313623348-8-19-2021-03-CC-KPES-C72N4T-20210920100828

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313623348
Report Date: 08/19/2021
Date Signed: 08/19/2021 01:38:46 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
08/05/2021 and conducted by Evaluator Katrina Owens

COMPLAINT CONTROL NUMBER: 03-CC-20210805094855

FACILITY NAME:	BUILDING KIDZ - ROSEVILLE WEST		FACILITY NUMBER:	313623348
ADMINISTRATOR:	VORONENKO, DARIA		FACILITY TYPE:	830
ADDRESS:	945 ROSEVILLE PARKWAY		TELEPHONE:	(916) 782-5437
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	16	CENSUS: 2	DATE:	08/19/2021
		UNANNOUNCED	TIME BEGAN:	07:25 AM
MET WITH:	Florisa Banford-Lucero, Assistant Director		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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LICENSE : Facility is out of ratio.
LACK OF SUPERVISION: Daycare child obtained injury while in care.

INVESTIGATION FINDINGS:

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An unannounced inspection was conducted today by Licensing Program Analyst Owens. LPA Owens met with Assistant Director Florisa Banford-Lucero. A census of children were taken. The purpose of the inspection is to close a complaint investigation that was originally opened on August 11, 2021.

Based on conflicting interviews, the allegation that the facility is operating out of ratio and child received an injury due to lack of supervision is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegations did or did not occur.

Exit interview conducted. Notice of site visit posted. Appeal rights given and explained.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 263-5728
LICENSING EVALUATOR NAME: Katrina Owens	TELEPHONE: 916-263-6280
LICENSING EVALUATOR SIGNATURE:	DATE: 08/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/19/2021

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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