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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343603167
Report Date: 07/30/2019
Date Signed: 07/30/2019 10:49:30 AM



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
05/17/2019 and conducted by Evaluator Jeevun Birk
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20190517140259
FACILITY NAME:ELITHA DONNER SCHOOL AGE CDCFACILITY NUMBER:
343603167
ADMINISTRATOR:MITCHELL, GRICELDAFACILITY TYPE:
840
ADDRESS:9461 SOARING OAKS DRIVETELEPHONE:
(916) 683-5526
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:98CENSUS: 11DATE:
07/30/2019
UNANNOUNCEDTIME BEGAN:
08:29 AM
MET WITH:Janice LalTIME COMPLETED:
10:50 AM
ALLEGATION(S):
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9
Teacher:Child Ratio - Facility is out of ratio
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Jeevun Birk-Miller and Chayntel Hunter conducted an unannouced complaint investigation and met with Janice Lal, Interim Site Supervisor. It was alleged that the facility is out of ratio. LPA Birk-Miller collected staff schedules for two weeks. LPA's did a count of teachers to children's and observed that the facility was in ratio. On 5/22/19 LPA's Birk-Miller and Joleen Kenney observed nine children to four staff and one site supervisor. On today's date 7/30/19 LPA's Birk-Miller and Hunter observed 11 children to four staff and one site supervisor. Through interviews with five of five staff it was stated that the ratios do exceed one teacher to 14 children. It was stated through interviews that staff make sure that ratios do not exceed one to 14 and that the site supervisor will step in to assist. It was stated through interviews that in the past there had been one incident where the facility was out of ratio but could not be recalled due to how long ago it was. It was stated by site supervisor that the protocol for when a teacher calls in sick or is unable to make it to work is to find another staff to fill in and that there is different sources to obtain staff coverage. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the findings are UNSUBSTANTIATED. Continued to 9099-C...
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2019
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 3
Control Number 53-CC-20190517140259
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: ELITHA DONNER SCHOOL AGE CDC
FACILITY NUMBER: 343603167
VISIT DATE: 07/30/2019
NARRATIVE
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No Title 22 deficiencies were cited at time of visit. An exit interview was conducted in which the report was reviewed and discussed with Site Supervisor, Janice Lal. Appeal rights were discussed, and a printed version was given. Notice of Site visit was provided and posted.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Jeevun BirkTELEPHONE: (916) 917-6078
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 3