293619733-4-16-2021-03-CC-KPES-C25U3K-20210416151339

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 293619733
Report Date: 04/16/2021
Date Signed: 04/16/2021 12:52:52 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
01/21/2021 and conducted by Evaluator Blake Morillas

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210121150740

FACILITY NAME:	ROBYN, JESSICA		FACILITY NUMBER:	293619733
ADMINISTRATOR:	ROBYN, JESSICA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 615-6908
CITY:	GRASS VALLEY	STATE: CA	ZIP CODE:	95945
CAPACITY:	14	CENSUS: 1	DATE:	04/16/2021
		UNANNOUNCED	TIME BEGAN:	12:42 PM
MET WITH:	Jessica Robyn		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Daycare children engaged in inappropriate behaviors.
Licensees were impaired while providing care to children.
Day care home smells of marijuana.

INVESTIGATION FINDINGS:

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*NOTE: Due to Covid-19 and DPH guidelines on physical distancing, the complaint findings were delivered via a phone call.*
On Friday, April 16th, 2021 at 12:42pm, LPA B Morillas contacted the Licensee, Jessica Robyn, to deliver findings of the complaint investigation into the above allegations. At the beginning of the phone call, the Licensee was asked how many children were present. The Licensee stated that 1 child was present.

It was alleged that Daycare children engaged in inappropriate behaviors. Through interviews conducted, inconsistent information was received and it could not be determined if these alleged behaviors took place at the child care. Based upon evidence obtained and interviews conducted, there is not a preponderance of evidence to prove or disprove that the allegation did or did not occur, therefore the above allegation is found to be UNSUBSTANTIATED.

CONTINUED ON LIC 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021

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 03-CC-20210121150740

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: ROBYN, JESSICA	FACILITY NUMBER: 293619733
	VISIT DATE: 04/16/2021

NARRATIVE

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It was alleged that the Licensees were impaired while providing care to children. During the investigation, an unannounced physical inspection was made and conversations was had with the Licensee and her spouse. It was admitted by the Licensee that they may occasionally drink acholic beverages, but they fervently denied doing so during day care hours. Based upon evidence obtained, observations made, and additional interviews conducted, there is not a preponderance of evidence to prove or disprove that the allegation did or did not occur, therefore the above allegation is found to be UNSUBSTANTIATED.

It was alleged that the day care home smells of marijuana. During the investigation, an unannounced physical inspection was made. With permission, and feeling safe to do so, I removed my mask when conducting the visit. Based upon evidence obtained, observations made, and interviews conducted, there is not a preponderance of evidence to prove or disprove that the allegation did or did not occur, therefore the above allegation is found to be UNSUBSTANTIATED.

This report (LIC 9099), Appeal Rights (LIC 9058) and a Notice of Site Visit (LIC 9213) will be delivered to the Licensee electronically via email.

Acknowledgement of delivery will constitute acknowledgement of the report in lieu of a signature.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Blake Morillas	TELEPHONE: (916) 208-3734
LICENSING EVALUATOR SIGNATURE:	DATE: 04/16/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2021

LIC9099 (FAS) - (06/04)

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