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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343604946
Report Date: 10/19/2023
Date Signed: 10/19/2023 12:01:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
10/05/2023 and conducted by Evaluator Katy Velazquez
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20231005120545
FACILITY NAME:CHILDTIME CHILDREN'S CENTERFACILITY NUMBER:
343604946
ADMINISTRATOR:JUANITA BELENFACILITY TYPE:
830
ADDRESS:7901 LAGUNA BOULEVARDTELEPHONE:
(916) 691-3800
CITY:ELK GROVESTATE: CAZIP CODE:
95758
CAPACITY:25CENSUS: 23DATE:
10/19/2023
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Juanita Belen TIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not maintain outdoor space free from hazard.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/19/2023, Licensing Program Analyst Katy Velazquez (LPA) conducted an unannounced complaint investigation to deliver the findings for the above allegation. LPA met with Assistant Director Juanita Belen (D1) as Director Roberts was unavailable. Throughout the course of the investigation, LPA conducted on-site observations, physical plant inspections, and interviews. LPA reviewed and collected documentation pertaining to the allegation. It was alleged that staff do not maintain outdoor space free from hazard.

Observations and interviews revealed that the playground, used soley by infants, is lacking a surface which adequetly abosorbs falls. Aditionally, the surface is not fully affixed to the ground which poses a tripping harzard; visible gaps in the cushioning also present tripping hazards.

Based on interviews and observations conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. A Type-B deficiency was cited on a subsequent 9099-D page. An exit interview was conducted, and the report was reviewed with D1.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Katy VelazquezTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
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-20231005120545
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 343604946
VISIT DATE: 10/19/2023
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
LPA provided Licensee Appeal Rights to D1. A Notice of Site visit was posted by LPA and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Katy VelazquezTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20231005120545
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: CHILDTIME CHILDREN'S CENTER
FACILITY NUMBER: 343604946
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/01/2023
Section Cited
CCR
101238.2
1
2
3
4
5
6
7
Outdoor Activity Space (d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned.
This requirement is not met as evidenced by LPA observation of playground surface and interviews.
1
2
3
4
5
6
7
The facility will repair or replace the surface on the infant playground by 12/01/2023. Until such time, the facilty will provide outdoor play for infants which does not comingle with other age groups. LPA will conduct an unannounced POC visit to clear the deficiency.
8
9
10
11
12
13
14
The unsafe condition of the infant playground surface poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR NAME: Katy VelazquezTELEPHONE: 916-926-9100
LICENSING EVALUATOR SIGNATURE:

DATE: 10/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/19/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3