343614523-2-21-2020-03-CC-KPES-BQ9KLJ-20200604080000

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343614523
Report Date: 02/21/2020
Date Signed: 02/21/2020 01:58:17 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
02/18/2020 and conducted by Evaluator Rosie Pitts

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20200218111024

FACILITY NAME:	SUNRISE COMMUNITY CHURCH PRESCHOOL		FACILITY NUMBER:	343614523
ADMINISTRATOR:	TRINITY WOOTEN		FACILITY TYPE:	850
ADDRESS:	8321 GREENBACK LN		TELEPHONE:	(916) 726-4642
CITY:	FAIR OAKS	STATE: CA	ZIP CODE:	95628
CAPACITY:	44	CENSUS: 17	DATE:	02/21/2020
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Trinity Wooten		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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Outside play area is unclean

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Rosie Pitts and Lea Habtom met with Director, Trinity Wooten to open a complaint regarding the above allegation. Upon arrival, LPAs observed 8 preschool aged children in the caterpillar class being supervised by 1 staff, and 9 preschool aged children in the butterfly class being supervised by 1 staff. During today's inspection, LPAs conducted observations and interviews, and obtained a copy of documents relevant to the complaint allegations.
LPAs observed a sandbox on the playground that contained debris. LPAs learned that the sandbox has not been maintained daily; although a portion of the sand has been covered with a tarp, the remaining portion is uncovered and there has been Incidences of animal feces that were discovered in the sandbox. Regulations states that sandboxes shall be inspected daily and kept free of hazardous foreign materials.
LIC9099-A continued on LIC9099-C

Substantiated

Estimated Days of Completion: 90

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

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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Control Number 03-CC-20200218111024

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: SUNRISE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 343614523
	VISIT DATE: 02/21/2020

NARRATIVE

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In an area accessible to children, LPAs observed a deep hole on the playground that was covered by a wooden board. LPAs also observed a long metal pole next to the wooden board. The director stated that the pole came off from the fence and removed it from the play area. LPAs learned that the wooden board is a tripping hazard to children in care. Regulations state that the surface of outdoor activity spaces shall be free of hazards including but not limited to holes and other debris.

Based on observations, interviews, and information obtained, the preponderance of evidence standard has been met; therefore, the above allegation are found to be SUBSTANTIATED.

Title 22 deficiencies cited on the attached LIC 809D. This facility evaluation report was reviewed and discussed with the licensee. A notice of site visit was issued and must remain posted for 30 days. Licensee acknowledged that a copy of this report will remain on file for a period of three years for public review upon request. Appeal Rights were also issued and discussed.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20200218111024

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: SUNRISE COMMUNITY CHURCH PRESCHOOL	FACILITY NUMBER: 343614523
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/21/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/23/2020 Section Cited CCR 101238.2(d)	1 2 3 4 5 6 7	The surface of outdoor activity space shall be maintained: free of hazards including, but not limited to holes, broken glass and other debris, and dry grasses that pose a fire hazard...Sandboxes shall be inspected	1 2 3 4 5 6 7	Director stated that she will speak to facilities regarding the sandbox and the hole. Director stated that If the hole is not fixed she will fill the hole with dirt.
	8 9 10 11 12 13 14	daily and kept free of hazardous foreign materials. This requirement has not been met as evidenced by: LPAs observed a sandbox with debris, a pole on the play yard and a hole covered by a board. This poses a potential risk to children 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: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 02/21/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2020

LIC9099 (FAS) - (06/04)

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