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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340309428
Report Date: 06/17/2024
Date Signed: 06/25/2024 10:44:15 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/16/2024 and conducted by Evaluator Jennifer Velasco
COMPLAINT CONTROL NUMBER: 03-CC-20240516093457
FACILITY NAME:SALVATION ARMY DAY CARE CENTERFACILITY NUMBER:
340309428
ADMINISTRATOR:LEONEL GUTIERREZFACILITY TYPE:
850
ADDRESS:2540 ALHAMBRA BLVDTELEPHONE:
(916) 469-4630
CITY:SACRAMENTOSTATE: CAZIP CODE:
95817
CAPACITY:72CENSUS: 15DATE:
06/17/2024
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Leonel GutierrezTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff did not prevent daycare child from being harmed by other children
Staff did not provide child's authorized representative with incident reports
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jennifer Velasco met with Facility Representative, Director Leonel Gutierrez (Director), for the purpose of conducting an unannounced complaint investigation inspection pertaining to the above allegation. The purpose of today's inspection was explained to Director. During the investigation, LPA conducted interviews, observed care, and obtained relevant documentation. Based on witness statements and document reviews, staff did not prevent a child in care from being harmed by other children in multiple incidents, with the child sustaining scrapes, bruises, and swelling when pushed, dragged, or hit with objects by other children. Based on witness statements and document reviews, while staff did provide authorized representative with incident reports for some incidents, staff did not provide a child's authorized representative with incident reports for multiple incidents in which the child was injured. The preponderance of evidence standard has been met, therefore, the above allegations are SUBSTANTIATED. The Facility Representative was informed that this report documents one Type A citation and must be posted for parental review for 30 consecutive days. The facility must also provide a copy of this licensing report 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 each child's file for verification. Exit interview was conducted and report was reviewed with Facility Representative, Leonel Gutierrez. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2024
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 2
Control Number 03-CC-20240516093457
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SALVATION ARMY DAY CARE CENTER
FACILITY NUMBER: 340309428
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/17/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/12/2024
Section Cited
CCR
101229(a)(1)
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The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time ... Supervision shall include visual observation. This requirement was not met as evidenced by:
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Director stated they have retrained staff on supervision, especially visual supervision and hiding spots, to reinforce the need to provide constant visual supervision without turning away or failing to observe. Director stated they will email the agenda and sign-in sheet to LPA on or before POC due date at jennifer.velasco@dss.ca.gov
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Based on witness statements and photographic evidence, the facility did not comply with the section cited above in failing to prevent a child from sustaining multiple injuries on multiple occasions. This is an immediate risk to health, safety, and or personal rights of children in care.
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Type B
07/12/2024
Section Cited
CCR
101226(a)(2)
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(a)The licensee shall immediately notify the child's authorized representative if the child becomes ill or sustains an injury more serious than a minor cut or scratch ... (2) In the case of less serious injuries ... the licensee shall document the injury in the child's record and notify the child's authorized representative ...
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Director stated they have retrained staff on the procedure and necessity of documenting and communicating to child's authorized representative in a timely manner. Director stated they will email the agenda and sign-in sheet to LPA on or before POC due date at jennifer.velasco@dss.ca.gov
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This requirement was not met as evidenced by: multiple witness statements and LPA records review that showed staff reported some incidents and did not report other incidents of injuries to a child. This constitutes a potential health, safety and/or personal rights risk to children in care.
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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: Natalie Dunaway
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2