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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 090309152
Report Date: 11/08/2021
Date Signed: 11/08/2021 03:03:00 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
11/04/2021 and conducted by Evaluator Mikah Martinez
COMPLAINT CONTROL NUMBER: 03-CC-20211104110008
FACILITY NAME:HAPPY KIDS PRESCHOOL & DAY CAREFACILITY NUMBER:
090309152
ADMINISTRATOR:ROBERTS, CINDYFACILITY TYPE:
850
ADDRESS:3900 PONDEROSA ROADTELEPHONE:
(530) 677-0551
CITY:SHINGLE SPRINGSSTATE: CAZIP CODE:
95682
CAPACITY:42CENSUS: 13DATE:
11/08/2021
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Trish RobertsTIME COMPLETED:
03:10 PM
ALLEGATION(S):
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Children are not required to wear masks.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Martinez conducted an unannounced complaint visit and met with Director Trish Roberts. The Director and LPA Martinez toured the facility inside and out. During the visit most of the children were observed on the outdoor play area. At 2:22PM LPA Martinez and the Director walked into the classroom for 2 year olds. 4 Children were observed in the 2's room without masks playing at a table together. The staff member in the classroom (S1) was observed wearing a mask. In an interview S1 stated the children are encouraged to wear masks but are not required. S1 and the Director stated children are provided a mask and masks were observed in the facility for children and staff to support those statements. All teachers observed during today's visit had masks on and were observed wearing them in the appropriate manner. Based on observations made by LPA Martinez on 11/8/21, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 & Chapter 1, are being cited on the attached LIC 9099D.

Notice of Site Visit must be posted for 30 days from todays visit.
Substantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Maria MayorgaTELEPHONE: (916) -26-1414
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (916) 862-1086
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 2
Control Number 03-CC-20211104110008
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 & DAY CARE
FACILITY NUMBER: 090309152
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/19/2021
Section Cited
CCR
101223(a)(2)
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The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by; Based on observations LPA Martinez observed 4 out of 4 children
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LPA Martinez discussed and provided COVID-19 guidelines to the Director regarding masks for children and staff. The Director agreed to holding a staff meeting to discuss with staff the appropriate protocol for reminding and enforcing mask wearing with children while inside. The Director shall send this in no later than 11/19/21.
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in the 2 year old room playing without masks on at the same table inside the classroom. This is a potential health and safety risk to 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: Maria MayorgaTELEPHONE: (916) -26-1414
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (916) 862-1086
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 2