343610520-9-2-2021-03-CC-SDLA-C6UMTF-20210914095326

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343610520
Report Date: 09/02/2021
Date Signed: 09/02/2021 01:29:49 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
08/25/2021 and conducted by Evaluator Alize Tillery

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210825095501

FACILITY NAME:	POPPY PATCH-PHASE III		FACILITY NUMBER:	343610520
ADMINISTRATOR:	TATE, SHANEL		FACILITY TYPE:	830
ADDRESS:	9638 BUTTERFIELD WAY		TELEPHONE:	(916) 845-4949
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95827
CAPACITY:	60	CENSUS: 19	DATE:	09/02/2021
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Shanel Tate		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Facility is comingling day care children

INVESTIGATION FINDINGS:

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On Thursday, September 2, 2021, at approximately 10:15 AM, Licensing Program Analysts (LPAs) Alize Tillery and Chris Bello, met with Director Shanel Tate, to conduct an unannounced inspection to initiate the complaint investigation regarding the above allegation. During today's visit, LPA toured the facility and observed 19 children and 6 staff.

On 8/20/2021 LPA Tillery cited for this deficiency as LPA observed staff member altering a 20 month old child back and forth from the infant and toddler room. Director has since completed the plan of correction.

Based on LPA observation on 8/20/2021, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. Per Licensing Program Manager (LPM) Seychelle De Luca, a second type A deficiency will not be sited at this time

LPAs reviewed the report with Director and provided copies. Appeal Rights were also issued and discussed. A Notice of Site Visit was issued, and Director acknowledges it must remain posted for 30 days.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 09/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2021

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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