093623367-7-13-2022-03-CC-NDUY-CGPPHQ-20220726112020

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 093623367
Report Date: 07/13/2022
Date Signed: 07/13/2022 11:09:44 AM

Substantiated

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
05/24/2022 and conducted by Evaluator Arianna Manabat

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220524151733

FACILITY NAME:	BUILDING KIDZ EL DORADO HILLS		FACILITY NUMBER:	093623367
ADMINISTRATOR:	KUNIS, SHELBY		FACILITY TYPE:	850
ADDRESS:	5041 ROBERT J MATTHEWS PRKY200		TELEPHONE:	(916) 358-5276
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	48	CENSUS: 27	DATE:	07/13/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Cindi Buccola		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility is out of ratio

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On July 13th, 2022 Licensing Program Analyst (LPA) Arianna Manabat and Licensing Program Manager (LPM) Natalie Dunaway met with Licensee Cindi Buccola at approximately 9:00 am to close a complaint. Upon arrival, LPA and LPM observed 27 preschool students in care with three staff and the Director.

It was alleged that the facility operates out of ratio. During the investigation, LPA inspected the facility, interviewed the Director, staff, parents, and Reporting Party (RP). Based on interviews and record review, the above allegation was found to be SUBSTANTIATED as it was confirmed that there are times when ratio is being exceeded. It was observed by LPA Manabat that teachers will come to the door with multiple children in care when there is an individual at the front door who needs to be let in. It was found through interviews that there are times when one staff will open the locked door for parents, leaving the other staff members out of ratio. ... Continued on 9099-C....

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna Manabat	TELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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 4

Control Number 03-CC-20220524151733

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: BUILDING KIDZ EL DORADO HILLS	FACILITY NUMBER: 093623367
	VISIT DATE: 07/13/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Through multiple interviews, it was found that the number of children that teachers are left alone with will fluctuate each day but that ratio was exceeded on multiple occasions. On one of these days it was found that Staff 1 (S1) was left alone with 23 children during play time. On a separate day it was alleged that Staff 2 (S2) was left alone with more than twelve children while Staff 3 (S3) answered the door for parents. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D.

Type A acknowledgement forms are to be signed by current parent of the facility and new parents for the next twelve months. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna Manabat	TELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

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
05/24/2022 and conducted by Evaluator Arianna Manabat

COMPLAINT CONTROL NUMBER: 03-CC-20220524151733

FACILITY NAME:	BUILDING KIDZ EL DORADO HILLS		FACILITY NUMBER:	093623367
ADMINISTRATOR:	KUNIS, SHELBY		FACILITY TYPE:	850
ADDRESS:	5041 ROBERT J MATTHEWS PRKY200		TELEPHONE:	(916) 358-5276
CITY:	EL DORADO HILLS	STATE: CA	ZIP CODE:	95762
CAPACITY:	48	CENSUS: 27	DATE:	07/13/2022
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Cindi Buccola		TIME COMPLETED:	11:40 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff are not following proper daily inspections of day care children

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Arianna Manabat and Licensing Program Manager (LPM) Natalie Dunaway met with Licensee Cindi Buccola on July 13th, 2022 at approximately 9:00am to deliver complaint finding for the allegation mentioned above. LPA and LPM observed 27 children in care being supervised by three staff and the Director.
It was alleged that staff members are not following proper daily inspections of day care children. Through interviews with the Director, staff members, parents, and the reporting party (RP), LPA found that the staff members are conducting daily inspections of the children and requiring that children are sent home if there are any symptoms of illness. Based on the information obtained, LPA was not able to determine that staff are not following proper daily inspection of daycare children, therefore, the allegation is determined to be UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it. An exit interview was conducted.
Notice of site visit and appeal rights were also addressed. The Notice of site visit shall remain posted for 30 days for guardian/parental review.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna Manabat	TELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

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

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 03-CC-20220524151733

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: BUILDING KIDZ EL DORADO HILLS	FACILITY NUMBER: 093623367
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/13/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/14/2022 Section Cited CCR 101216.3(a)	1 2 3 4 5 6 7	101216.3 (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance… this requirement was not met as evidenced by:	1 2 3 4 5 6 7	Licensee will provide a written agenda to the Licensing department which shows what ratio requirements are iwithin the meeting and will show proof of ratio being met on the Plan of Correction due date.
	8 9 10 11 12 13 14	Based on interviews, the facility did not comply with the above regulation as there were multiple occassions where one teacher was supervising more than twelve children, which poses a Health, Safety, or Personal Rights risk to persons in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Arianna Manabat	TELEPHONE: (279) 200-2886
LICENSING EVALUATOR SIGNATURE:	DATE: 07/13/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2022

LIC9099 (FAS) - (06/04)

Page: 4 of 4