313610265-5-1-2019-03-CC-KPES-BBXL9Z-20190507083423

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313610265
Report Date: 05/01/2019
Date Signed: 05/01/2019 01:59:13 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
04/22/2019 and conducted by Evaluator Jeremey McClain

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20190422151512

FACILITY NAME:	CADENCE EDUCATION, INC - THEONA		FACILITY NUMBER:	313610265
ADMINISTRATOR:	AGUIRRE, SUZIE		FACILITY TYPE:	830
ADDRESS:	2820 THEONA WAY		TELEPHONE:	(916) 415-0780
CITY:	ROCKLIN	STATE: CA	ZIP CODE:	95765
CAPACITY:	36	CENSUS:	DATE:	05/01/2019
		UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Suzie Aguirre		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff interacted with child in an inappropriate manner

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Jeremey McClain met with Suzie Aguirre for the purpose of a complaint investigation. LPA observed 11 infants supervised by four staff members in one room, and 13 infants supervised by five staff members in another room.

It was alleged that staff interacted with children in an inappropriate manner. During the investigation, LPA conducted interviews and reviewed footage of two incidents that occurred in April. The incidents were self-reported by the facility on an Unusual Incident Report that was received via fax on April 17th, 2019. On 04/14/2019, a now former staff member stepped on an infant child’s foot intentionally in one incident. On the same day, another staff member pulled an infant child off of a bike in a manner that could have been harmful to the child. Based on the evidence that was gathered, LPA determined the allegation to substantiated. The preponderance of evidence standard has been met.

Report continued on the following page...

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

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 03-CC-20190422151512

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: CADENCE EDUCATION, INC - THEONA	FACILITY NUMBER: 313610265
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/02/2019 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	Personal Rights. The licensee shall ensure that each child is accorded the following personal rights:(1) To be accorded dignity in his/her personal relationships with staff and other persons.This requirement was not met as evidenced by	1 2 3 4 5 6 7	S1 has been terminated since the incident occured. S2 was supsended during investigation but has since been retrained with the rest of staff on children's rights, behavior guidance, safe lifting, and mandated reporting. Director has provided LPA with an agenda of the meeting that was held on 04/18/2019 and signatures of staff that attended the training.
	8 9 10 11 12 13 14	LPA's observation of video footage, and the Unusual Incident Reported received on April 17th, 2019. On April 14th, Video footage shows S1 stepping on C1's foot intentionally, and also show S2 agressively pulling a child off of a bike inside the classroom. This is considered an immediate risk to the health and safety of children 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: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

LIC9099 (FAS) - (06/04)

Page: 3 of 3

Control Number 03-CC-20190422151512

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: CADENCE EDUCATION, INC - THEONA	FACILITY NUMBER: 313610265
	VISIT DATE: 05/01/2019

NARRATIVE

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A Type A Citation will be issued today for violation of Personal rights under Title 22 Regulation 101223(a)(1).

The Director acknowledges, that for TYPE A DEFICIENCIES ONLY upon receipt, a LIC 9099-D with Type A deficiencies shall be posted for 30 days, copies of this licensing report shall be provided to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Director. LIC 9224 and Appeal Rights were provided.

This report was reviewed with the director, and a Notice of Site Visit was provided to be posted.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Jeremey McClain	TELEPHONE: (916) 216-7801
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 3