343610520-12-15-2021-03-CC-SDLA-CA6VJK-20211229152853

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343610520
Report Date: 12/15/2021
Date Signed: 12/15/2021 03:38:19 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
11/04/2021 and conducted by Evaluator Alize Tillery

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20211104145221

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: 20	DATE:	12/15/2021
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Shanel Tate		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility is operating out of ratio.

INVESTIGATION FINDINGS:

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On Wednesday, December 15, 2021, at approximately 8:15 AM, Licensing Program Analyst (LPA) Alize Tillery, 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 10 infant children supervised by two fully qualified teachers and one aide, and 10 toddler children being supervised by two aides.

During LPAs initial visit on November 10, 2021, LPA Tillery observed 11 infant children supervised by four staff and 13 toddler children supervised by two staff.

It was alleged that the facility was operating out of ratio. Based on observations and record review the preponderance of evidence standard has been met therefore the allegation is founded to be SUBSTANTIATED. On 7/23/2021, the facility was cited for the same allegation. This is a repeat violation, therefore a civil penalty will be assessed in the amount of $250.

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: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

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 4

Control Number 03-CC-20211104145221

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: POPPY PATCH-PHASE III	FACILITY NUMBER: 343610520
	VISIT DATE: 12/15/2021

NARRATIVE

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Upon receipt, Director shall post and provide copies of this licensing report to parents/guardians of children who are currently enrolled as well as parents/guardians of children newly enroll at the facility during the next 12 months. Parents/guardians must acknowledge receipt of this report and citation by signing a LIC 9224, “ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS”. A copy of this form should be placed in each child file upon receipt from parent.

See 9099D for the cited deficiency.

LPA 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

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 03-CC-20211104145221

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: POPPY PATCH-PHASE III	FACILITY NUMBER: 343610520
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/15/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/16/2021 Section Cited HSC 1596.956(4)	1 2 3 4 5 6 7	A ratio of six children to each teacher shall be maintained for all children in attendance at the toddler program. An aide who is participating in on-the-job training may be substituted for a teacher when directly supervised by a fully qualified teacher.	1 2 3 4 5 6 7	Deficiency will be cleared by LPA follow-up inspection.
	8 9 10 11 12 13 14	Based on observation and record review, this requirement was not met, evidenced by: LPA observed 10 toddlers being supervised by 2 aides, upon arrival.	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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Alize Tillery	TELEPHONE: (916) 216-7798
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

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
11/04/2021 and conducted by Evaluator Alize Tillery

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20211104145221

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: 20	DATE:	12/15/2021
		UNANNOUNCED	TIME BEGAN:	08:15 AM
MET WITH:	Shanel Tate		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility is dirty.
Staff are not responding to a day care child with persistent crying.

INVESTIGATION FINDINGS:

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On December 15, 2021, Licensing Program Analyst (LPA) Alize Tillery met with Director Shanel Tate, to conduct an unannounced inspection to initiate the complaint investigation regarding the above allegations.

It was alleged that the “Facility is dirty”. Based on LPA observation and staff interviews, the facility is cleaned throught the day, as well as at the beginning and end of each shift. Staff disinfect children's toys and equipment and mop/vaccuum the floors daily.
It was also alleged that "staff do not respond to children who persistently cry". Based on LPA observation and staff interviews, staff do not neglect crying children and parents are informed if their children cry more than usual.

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 allegations are Unsubstantiated. There were no Title 22 deficiencies cited. An exit interview was conducted and a Notice of Site Visit posted.

Unsubstantiated

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: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 4