343603671-10-1-2021-03-CC-MMAA-C7KNUS-20211007104645

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343603671
Report Date: 10/01/2021
Date Signed: 10/01/2021 02:55:49 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
07/21/2021 and conducted by Evaluator Gagandeep Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210721145849

FACILITY NAME:	SETA - MATHER HEAD START		FACILITY NUMBER:	343603671
ADMINISTRATOR:	MALDONADO, JENNIFER		FACILITY TYPE:	850
ADDRESS:	10546 PETER A. MCQUEN RD.		TELEPHONE:	(916) 563-5057
CITY:	MATHER	STATE: CA	ZIP CODE:	95655
CAPACITY:	90	CENSUS: 0	DATE:	10/01/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Jennifer Maldonado		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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A daycare child sustained injuries while in care.
Facility staff did not report a child's injury to the representative.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gagandeep Singh met with facility representative, Jennifer Maldonado, to deliver the findings of the above allegations. Purpose of the inspection was explained.

During the investigation, LPA inspected the entire facility, interviewed the staff members and parents, did the observation of the facility activities and reviewed the facility records. Through the facility records and interviews, it was found that there were children, who got hurt during the activities at the facility. Although it was observed that children had accidents, LPA did not observe any violation of regulations which leads to the injuries of the children. LPA suggested the facility to improve the supervision to prevent any future accidents. During investigation, it was found that facility communicates with the children’s representative through phone call and written reports, if any child gets hurts/injured. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated.
Copy of this report was reviewed and provided to the facility representative. Notice of site visit is posted and shall remain posted for next 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2021

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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