<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340314892
Report Date: 04/07/2022
Date Signed: 04/07/2022 02:12:25 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
01/28/2022 and conducted by Evaluator Jan Hoshida
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220128164943
FACILITY NAME:GENERAL DAVIE, JR. PRIMARY CENTERFACILITY NUMBER:
340314892
ADMINISTRATOR:ANDREWS,J/MARRIOTT,LFACILITY TYPE:
850
ADDRESS:1500 DOM WAYTELEPHONE:
(916) 971-7375
CITY:SACRAMENTOSTATE: CAZIP CODE:
95864
CAPACITY:296CENSUS: 0DATE:
04/07/2022
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Stacey ShoreyTIME COMPLETED:
02:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Neglect/Lack of Supervision: Children are being hit by another child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Thursday, 04/07/2022, Licensing Program Analyst (LPA) Jan Hoshida conducted an unannounced inspection of the facility and met with ECE Administrator Stacey Shorey to deliver findings and conclude the complaint investigation of the above allegation. Upon arrival, LPA observed there were no children present at the facility due to early dismissal day.

It was alleged that children are being hit by another child in care.

During the investigation, LPA inspected the facility, conducted observations of staff and children and conducted interviews with pertinent parties. LPA reviewed facility files and obtained records relevant to the complaint investigation.

REPORT CONTINUED ON NEXT PAGE
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022
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 2
Control Number 03-CC-20220128164943
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: GENERAL DAVIE, JR. PRIMARY CENTER
FACILITY NUMBER: 340314892
VISIT DATE: 04/07/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
It was alleged that Child #1 has hit or slapped several children in care while Staff #1 does not inform parents of the incidents. During the investigation, LPA observed that Staff #1 shadows Child #1 throughout the classroom and facilitates social interactions with other children. Based on interviews, staff have advocated for children with challenging behaviors to receive support services within the classroom and home, behavioral plans have been created, and incidents are documented. All parents interviewed stated that they do not have any concerns regarding the facility or staff and their children have minimal age-appropriate accidents or injuries at the facility which have been communicated to them by the teachers.

Based upon the lack of preponderance of evidence after interviews and observations to prove the alleged violation did or did not occur, the allegation is unsubstantiated. No deficiencies were cited.

Appeal Rights were discussed, an exit interview was conducted, and the Notice of Site Visit was posted.
SUPERVISOR'S NAME: Seychelle De LucaTELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Jan HoshidaTELEPHONE: (916) 917-6572
LICENSING EVALUATOR SIGNATURE:

DATE: 04/07/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/07/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2