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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 090308259
Report Date: 11/08/2021
Date Signed: 11/08/2021 11:49:11 AM



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
11/04/2021 and conducted by Evaluator Amanda Blesi
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20211104111234
FACILITY NAME:HAPPY KIDS PRESCHOOL AND DAY CARE - COLOMAFACILITY NUMBER:
090308259
ADMINISTRATOR:YVONNE BEALFACILITY TYPE:
850
ADDRESS:2786 COLOMA STREETTELEPHONE:
(530) 626-0344
CITY:PLACERVILLESTATE: CAZIP CODE:
95667
CAPACITY:30CENSUS: 11DATE:
11/08/2021
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Fatima Guerra, (teacher)TIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff are not requiring children to wear masks
Facility is dirty
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Amanda Blesi met with teacher Fatima Guerra to open and close the complaint. Director Yvonne Beal was out sick today. Upon arrival, LPA observed two staff wearing a face covering while indoors. A third staff was not wearing a face covering in the kitchen; however upon seeing LPA walk in, she immediately put one on. Out of the 11 children in care, none of the children were wearing a face covering while indoors. Staff state they ask children if they want to wear a mask each day but some parents request their child not wear one. LPA interviewed staff regarding cleaning procedures in the facility. LPA learned that they have one designated staff that does most of the cleaning. If that staff person is out for some reason, the staff working that day will pitch in and clean their own classrooms and the bathroom. Staff state they sweep and mop floors and sanitize toys and surfaces daily. During today's inspection, the floors had not been cleaned since children were last in care and floors looked unclean. Interviews revealed the opener was supposed to do the mopping this morning before kids arrived, however kids started showing up early so the floors did not get mopped today. Based on today's inspection and interviews, the allegations the facility is dirty and staff are not requiring children to wear masks are substantiated. (Report continued on the following page...)
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 03-CC-20211104111234
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: HAPPY KIDS PRESCHOOL AND DAY CARE - COLOMA
FACILITY NUMBER: 090308259
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/15/2021
Section Cited
CCR
101238(a)
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Buildings and Grounds: The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
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To correct this deficiency, director shall submit to LPA a written schedule showing which staff will complete the cleaning duties and how often. This shall be done by 11/15/21.
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This requirement was not met as evidenced by: the floors had not been cleaned since children were last in care. If not corrected, this could pose a risk to the health and safety of children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20211104111234
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: HAPPY KIDS PRESCHOOL AND DAY CARE - COLOMA
FACILITY NUMBER: 090308259
VISIT DATE: 11/08/2021
NARRATIVE
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Title 22 deficiencies are noted on the subsequent page of this report. See LIC 9099-D. A technical violation was issued regarding the COVID-19 guidelines staff and children wearing face coverings.

Exit interview with Cindy Roberts.
Notice of Site Visit provided.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda BlesiTELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3