313617066-3-8-2022-03-CC-KPES-CCJJAR-20220315065309

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313617066
Report Date: 03/08/2022
Date Signed: 03/08/2022 02:31:45 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
03/07/2022 and conducted by Evaluator Amanda Blesi

COMPLAINT CONTROL NUMBER: 03-CC-20220307114250

FACILITY NAME:	BUNGER, ALEXANDRIA		FACILITY NUMBER:	313617066
ADMINISTRATOR:	BUNGER, ALEXANDRIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 899-9603
CITY:	LINCOLN	STATE: CA	ZIP CODE:	95648
CAPACITY:	14	CENSUS: 5	DATE:	03/08/2022
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Effie Greer-Roberts		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Licensee left children in the car without supervision.

INVESTIGATION FINDINGS:

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Licensing Program Analyst Amanda Blesi arrived unannounced to open the above complaint. LPA was met by day care assistant Effie Greer-Roberts. There were 5 napping day care children present and assistant's spouse James Robert's. Licensee Alexandria Bunger was not present today. Ms. Greer-Roberts had to do a school pick up to get one school age child soon after LPA arrived. LPA went out to her car to work on the report while assistant was away. During the investigation, Ms. Greer-Roberts admitted that she left two children unattended in the day care van on 3/8/22 when she stepped away to talk to the gas station attendant. Based on the information gathered and Ms. Greer-Roberts's statements, the allegation above is subtantiated. This is a zero tolerance violation; Civil Penalties are assessed in the amount of $500.

Title 22 Deficiencies are cited on the following page; See LIC9099-D

Report is continued on the following page see LIC9099-C

Substantiated

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: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 3

Control Number 03-CC-20220307114250

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: BUNGER, ALEXANDRIA	FACILITY NUMBER: 313617066
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/08/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/09/2022 Section Cited CCR 102417(k)(1)	1 2 3 4 5 6 7	Operation of a family child care home: children shall not be left in parked vehicles.	1 2 3 4 5 6 7	Ms. Effie Greer-Robert's states she stepped away for a few minutes to talk to the attendant when her card was not working at the pump. She understands this is a violation of Title 22 regulaitons. To correct the deficiency, she shall submit a statement of understanding showing that she agrees not to leave children unattended in a parked vehicle.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: assistant, Effie Greer-Robert's states that on 3/8/22, she left two children aged 13 months and 2 years in the day care van when she stepped away to see the gas station attendant at the AM/PM when she was pumping gas. This is an immediate threat to the health and safety of children in care. This is a zero tolerance violation and civil penalties are assessed.	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: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 03-CC-20220307114250

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: BUNGER, ALEXANDRIA	FACILITY NUMBER: 313617066
	VISIT DATE: 03/08/2022

NARRATIVE

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Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.
Also, LPA Amanda Blesi informed the facility representative Effie Greer to provide a copy of this licensing report dated 3/8/22 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Appeal Rights given.

Exit interview with Effie Greer
Notice of Site Visit provided.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Amanda Blesi	TELEPHONE: (916) 208-3427
LICENSING EVALUATOR SIGNATURE:	DATE: 03/08/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2022

LIC9099 (FAS) - (06/04)

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