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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340320568
Report Date: 07/16/2020
Date Signed: 07/16/2020 04:01:14 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
02/27/2020 and conducted by Evaluator Mai Lor
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20200227164340
FACILITY NAME:KINDER WORLDFACILITY NUMBER:
340320568
ADMINISTRATOR:BREEDING, MARYFACILITY TYPE:
830
ADDRESS:6565 BELLEAU WOOD LANETELEPHONE:
(916) 422-5437
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:13CENSUS: 0DATE:
07/16/2020
UNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Mary BreedingTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff did not inform day care child's parents of dispensing of medication
INVESTIGATION FINDINGS:
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Due to COVID-19 pandemic, Licensing Program Analyst (LPA) Mai Lor conducted a virtual complaint investigation follow-up via Zoom with licensee/owner Mary Breeding on 7/16/20 regarding the above allegation. During the investigation, LPA Lor conducted interviews with parents, staff, and reviewed relevant documents including children’s roster and children’s files.

The complaint alleged staff did not inform day care child’s parents of dispensing of medication. Staff interviews were inconsistent to determine whether the parents/authorized representatives were notified when prescribed and non- prescribed medications were administered. Children’s records did not indicate any unusual medication documentation. Parent interviews did not reveal concerns regarding administration of medication. However, this information conflicts with the information provided by the complainant. LPA Lor reiterated the importance of developing and implementing a plan to inform the child’s authorized representative daily when such medications have been given.
(Report continued on subsequent page)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2020
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-20200227164340
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: KINDER WORLD
FACILITY NUMBER: 340320568
VISIT DATE: 07/16/2020
NARRATIVE
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Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that staff did not inform day care child’s parents of dispensing of medication, therefore the allegation is unsubstantiated.

Exit interview conducted. In lieu of licensee's signature, LPA Lor is e-mailing the report, appeal rights and notice of site visit to the licensee/owner with a read receipt request. Per licensee/owner, she will review the report and director of operations David Esbin will sign the report.
SUPERVISOR'S NAME: Roxana SaraviaTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mai LorTELEPHONE: (916) 491-0182
LICENSING EVALUATOR SIGNATURE:

DATE: 07/16/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2