150408907-8-27-2021-04-CC-DLEN-C6FR9Z-20210901125020

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 150408907
Report Date: 08/27/2021
Date Signed: 08/27/2021 04:55:34 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/07/2021 and conducted by Evaluator Peter Espinoza

COMPLAINT CONTROL NUMBER: 04-CC-20210707162634

FACILITY NAME:	GREENFIELD COUNTRY PRESCHOOL		FACILITY NUMBER:	150408907
ADMINISTRATOR:	HASKINS/HALL		FACILITY TYPE:	830
ADDRESS:	7690 S. UNION		TELEPHONE:	(661) 834-8184
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93307
CAPACITY:	24	CENSUS: 4	DATE:	08/27/2021
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Traci Myers, Director		TIME COMPLETED:	05:15 PM

ALLEGATION(S):

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Staff are not following safe sleep practices

INVESTIGATION FINDINGS:

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On 08/27/2021, Licensing Program Analyst (LPA) Pete Espinoza arrived at the facility unannounced to complete the investigation into the above allegation. LPA met with Traci Myers, Director and toured the facility. LPA explained the reason for this inspection with Director and census was taken.

Based upon observations and information gathered through interviews, the Licensing agency has determined the preponderance of evidence standards has been met, therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter (1/3), are being cited on the attached LIC 9099D.

An exit interview was conducted with Traci Myers, Licensee, a plan of correction was discussed, and appeal rights were explained. A printed copy of this report as well as a printed copy of the appeal rights was provided at the conclusion of the visit.
LIC 9213 NOTICE OF SITE VISIT FORM IS REQUIRED TO BE POSTED FOR 30 DAYS.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

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 04-CC-20210707162634

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: GREENFIELD COUNTRY PRESCHOOL	FACILITY NUMBER: 150408907
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/27/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/24/2021 Section Cited HSC 101430(a)(3)(E)	1 2 3 4 5 6 7	Infant Care Activities - If an infant falls asleep before being placed in a crib, staff shall move the infant to a crib as soon as possible. This requirement is not met as evidenced by interviews with witnesses conducted during today’s complaint investigation.	1 2 3 4 5 6 7	Licensee shall provide a written statement acknowledging that sleeping infants are to be removed from swing and placed in crib in a timely manner. Licensee shall provide training to staff.
	8 9 10 11 12 13 14	Staf failed to move sleeping infants from swing to crib in a timely manner. This poses an potential risk to the health, safety or personal rights of children in care.	8 9 10 11 12 13 14	Licensee will send in a copy of written statement, training agenda, and attendance to the Fresno Community Care Licensing office by 09/24/2021.
	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: Diana deLeon	TELEPHONE: (559) 650-7854
LICENSING EVALUATOR NAME: Peter Espinoza	TELEPHONE: 661-644-8231
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2021

LIC9099 (FAS) - (06/04)

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