340306386-10-26-2022-03-CC-SDLA-CKQMBB-20221031092737

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 340306386
Report Date: 10/26/2022
Date Signed: 10/26/2022 04:53:47 PM

Substantiated

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
08/03/2022 and conducted by Evaluator Josiah Gathing

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220803135253

FACILITY NAME:	OAK PARK PRESCHOOL		FACILITY NUMBER:	340306386
ADMINISTRATOR:	MORGAN, PAMELA		FACILITY TYPE:	850
ADDRESS:	3500 2ND AVENUE		TELEPHONE:	(916) 451-9498
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95817
CAPACITY:	34	CENSUS: 6	DATE:	10/26/2022
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Arcie Currie		TIME COMPLETED:	05:00 PM

ALLEGATION(S):

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Personal Rights

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Josiah Gathing met with Director Arcie Curry, on October 26, 2022 at approximately 2:30 PM to continue and close the above complaint investigation. The complaint alleged that a child was held in place between staff member's legs and staff member placed a hand over the child's mouth to quiet the child. Investigator Andrew Murrow from the Department's Investigation Branch interviewed children and obtained the police report. Through these reports and interviews, the investigator found evidence to support the allegations.
Based on IB investigation and reports, as well as LPA investigation, LPA determined the preponderance of evidence standard has been met, and the allegation is substantiated.
CONT. ON 9099-C...

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

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-20220803135253

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: OAK PARK PRESCHOOL	FACILITY NUMBER: 340306386
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/26/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/27/2022 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	101223 Personal Rights (a) The licensee shall ensure following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation... This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director will submit a plan to the LPA demostrating that this issue will be addressed and resolved by the POC date.
	8 9 10 11 12 13 14	Based on interviews and record review the facility did not comply with the above regulation as a child was held in place and staff member placed a hand over the child's mouth to quiet the child which poses Health, Safety, or Personal Rights risk to persons 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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 03-CC-20220803135253

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: OAK PARK PRESCHOOL	FACILITY NUMBER: 340306386
	VISIT DATE: 10/26/2022

NARRATIVE

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Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report 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 licensee. LIC 9224 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
Upon receipt, facility representative shall post and provide copies of this licensing report to parents/ guardians of children who are currently enrolled as well as parents/ guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.
LPA discussed this report with Director and conducted an exit interview. LPA also provided appeal rights. Notice of site visit will be posted.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Josiah Gathing	TELEPHONE: (916) 799-9668
LICENSING EVALUATOR SIGNATURE:	DATE: 10/26/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/26/2022

LIC9099 (FAS) - (06/04)

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