090306370-9-27-2019-03-CC-BENN-BGJMEK-20191001093250

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 090306370
Report Date: 09/27/2019
Date Signed: 09/27/2019 03:53:04 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/26/2019 and conducted by Evaluator Elvira Sierra

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20190726093330

FACILITY NAME:	LAKE TAHOE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	090306370
ADMINISTRATOR:	RODRIGUEZ,PATRICIA		FACILITY TYPE:	850
ADDRESS:	3441 SPRUCE AVENUE		TELEPHONE:	(530) 541-5897
CITY:	SOUTH LAKE TAHOE	STATE: CA	ZIP CODE:	96150
CAPACITY:	48	CENSUS: 11	DATE:	09/27/2019
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Christy Calverley		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Care and Supervision - Lack of supervision resulted in child's injury
Personal Rights-Facility staff left day care child in soiled clothing for an extended period of time
Personal Rights-Facility staff failed to provide a safe environment for daycare children

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Elvira Sierra and Licensing Program Manager (LPM) Bettina Engelman met with Assistant Director, Christy Calverley to provide her with the finding of the above complaint allegations. Present in the facility were 3 staff caring for 11 preschool children.

The complainant alleged due to a lack of supervision child #1 sustained an injury resulting in child’s tooth half broken and that child # 1 was also left in soiled clothing for an extended period. Complainant also alleged that facility failed to provide a safe environment for daycare children. LPA interviewed parents, staff and children and obtained pertaining information. Through interviews it was revealed child # 1 running after a child tripped and fell hitting his/her mouth with the steel steps designated to reach the monkey bars. Staff were present and observed the incident and attended child #1 immediately. Through the interviews with staff LPA learned that child # 1 refused to move from his/her napping equipment when he/she had the potty accident and staff didn’t want to force child to go to the bathroom to change. However, parents were informed immediately of the incident. It was also disclosed in interviews that children are never allowed to play in the school age structures and children are redirected by staff to the small play equipment.
Report continued on subsequent page 9099D..

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20190726093330

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833

FACILITY NAME: LAKE TAHOE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 090306370
	VISIT DATE: 09/27/2019

NARRATIVE

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Based on the information obtained through documentation and interviews; although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated

No Title 22 Deficiencies cited, and Notice of Site Visit posted.

An Exit Interview was conducted in which the report was reviewed and discussed with Director Assistant. Appeals of Rights were provided.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 09/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2019

LIC9099 (FAS) - (06/04)

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