313611330-5-26-2021-03-CC-KPES-C3NL2K-20210604082229

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313611330
Report Date: 05/26/2021
Date Signed: 05/26/2021 01:44:24 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
05/03/2021 and conducted by Evaluator Amanda Blesi

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210503155818

FACILITY NAME:	NELSON, ELLEN		FACILITY NUMBER:	313611330
ADMINISTRATOR:	NELSON, ELLEN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 626-9570
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	14	CENSUS: 9	DATE:	05/26/2021
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Ellen Nelson		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Licesnee handled daycare children in a rough manner

INVESTIGATION FINDINGS:

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On 5/26/21 at approximately 1:40pm, due to the COVID-19 pandemic, Licensing Program Analyst (LPA), Amanda Blesi, conducted a tele-inspection via Facetime video and met with licensee, Ellen Nelson, to deliver findings and conclude the complaint investigation which was opened on 5/3/21. Census was 9 children supervised by Nelson and assistant Madi. It was alleged that licensee handled children in a rough manner while at a public park. According to witness statements, there was no point where licensee’s handling of the children seemed out of line; however, there was conflicting information received throughout the investigation. This allegation has been investigated and although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED.

An exit interview was conducted and Notice of Site Visit was provided to be posted for 30 days. Facility evaluation report was emailed to licensee and an email verification of receipt of report will be used in lieu of a signature on this report.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 05/26/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2021

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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