213005161-12-4-2019-05-CC-AMAG-BJY23T-20191217160251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 213005161
Report Date: 12/04/2019
Date Signed: 12/04/2019 11:46:00 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/30/2019 and conducted by Evaluator Luis Gomez

COMPLAINT CONTROL NUMBER: 05-CC-20190930131947

FACILITY NAME:	UNIVERSITY OF PLAY		FACILITY NUMBER:	213005161
ADMINISTRATOR:	STOWELL, SYLVIA		FACILITY TYPE:	850
ADDRESS:	1055 LAS OVEJAS AVE RM#4		TELEPHONE:	(415) 499-0309
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	30	CENSUS: 23	DATE:	12/04/2019
		UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Director, Sylvia Ballenger		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Facility staff kicked child in care
Facility staff handled child in a rough manner
Facility staff yelled at child in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis J. Gomez met with the Director, Sylvia Ballenger, for a complaint investigation of above allegation. Purpose of the inspection was explained. Present is the director and 6 staff supervising 23 preschool children. LPA Gomez inspected facility with director for health and safety hazards.

During today's inspection LPA interviewed children, director and performed site observations.

As part of this investigation, LPA conducted inspections of the facility on 10/01/2019, 11/20/19 and 12/4/2019 and did an evaluation the supervision of the children.
A review of facility records was also completed which included a review of the children's roster, children’s records, personnel records, personnel roster, facility policy and practices related to working with the children. Also, as part of this complaint investigation, interviews were conducted with the director, random sample of parents, children and staff.

Continue on 9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019

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 05-CC-20190930131947

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: UNIVERSITY OF PLAY	FACILITY NUMBER: 213005161
	VISIT DATE: 12/04/2019

NARRATIVE

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Regarding he allegation of facility staff kicked child in care. Based on interviews with the director, staff and children, LPA is unable to determine if facility staff kicked a child in care. Site policy regarding discipline is to construct an all-inclusive, positive learning environment to keep children safe.

Regarding the allegation of facility staff handled child in a rough manner. Based on the interviews conducted with director, staff and children, LPA is unable to determine if facility staff handled child in a rough manner. Site protocol for staff is to use respectful intervention methods such as redirection and positive reinforcement when assisting the children.

Regarding the allegation of facility staff yelled at a child in care. Based on the interviews conducted and site observations of the staff- children interactions, LPA is unable to determine if facility staff yelled at child in care. LPA observed facility staff using respectful language during their interactions with the children.

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated. Copy of this report is reviewed and provided to the director. No deficiencies are cited.

Exit interview was conducted with director, Sylvia Ballenger. LPA observed notice of site visit was posted in the facility.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019

LIC9099 (FAS) - (06/04)

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