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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343615108
Report Date: 11/05/2021
Date Signed: 11/05/2021 01:24:41 PM

Substantiated


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
11/03/2021 and conducted by Evaluator Katrina Owens
COMPLAINT CONTROL NUMBER: 03-CC-20211103090153
FACILITY NAME:WOODRIDGE PRESCHOOL CENTERFACILITY NUMBER:
343615108
ADMINISTRATOR:MAI VANGFACILITY TYPE:
850
ADDRESS:5950 REVELSTOK DRIVETELEPHONE:
(916) 893-7814
CITY:SACRAMENTOSTATE: CAZIP CODE:
95842
CAPACITY:94CENSUS: 28DATE:
11/05/2021
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Mai Vang - Site SupervisorTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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PHYSICAL PLANT Facility has pests.
PHYSICAL PLANT: Facility trash cans are not emptied daily, resulting in a bad odor.
PHYSICAL PLANT: Facility is not maintained clean and sanitary.
INVESTIGATION FINDINGS:
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An unannounced inspection was conducted today by Licensing Program Analyst Owens and Blesi. LPA's met with Site Supervisor Mai Vang. The purpose of the inspection is to open and close a complaint investigation.

Based on interviews and LPA's observation the facility is having a problem with rodents outside the facility classrooms, pest inside the classrooms, garbage cans not being emptied or cleaned / washed out on a daily basis leaving the classroom with an odor. The restrooms and the floors in the classrooms are not being cleaned on a regular basis. None of the above areas are being cleaned by the custodians that are assigned to this center.
The preponderance of evidence standard has been met during this investigation, therefore the above allegation is found to be SUBSTANTIATED. Violations of the California Code of Regulations, Title 22, Division 12 & Chapter 3 are being cited on the attached LIC9099D.

This is a Type A deficiency, hence AB633 Notification Applies: Upon receipt of this report, the report must be posted along with the notice of site visit for 30 days for parents to view. Licensee must inform the parents/guardians of children in care at the facility and to the parents/guardians of children newly enrolled at the facility during the next 12 months via form LIC 9224 Acknowledgement of Receipt of Licensing Reports.
Notice of site visit provided at time of inspection.
Appeal Rights provided to Teacher on Special Assignment (TOSA) Lena Saunders.
Exit interview conducted.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
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 2
Control Number 03-CC-20211103090153
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: WOODRIDGE PRESCHOOL CENTER
FACILITY NUMBER: 343615108
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/08/2021
Section Cited
CCR
101238(a)(1)
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BUILDING AND GROUNDS:
The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
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The Teacher on Special Assignment (TOSA), Lena Saunders stated she will notify the School District about the deficiency and have them notify the pest control to come to the Center. She will submit proof that the pest control have been notified. The custodians will also be contacted to have them come clean the facility. She will submit documentation from the Administration regarding the cleaning schedule of the center.
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The licensee shall take measures to keep the center free of flies, other insects, and rodents. This requirement was not met as interviews the facility is having a problem with rodents and pest. Facility not being cleaned on a regular basis. This is a immediate risk to children.
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LIC 9224 form was given to Ms. Saunders at time of inspection.
If deficiency is not correction by due date a civil penalty may be accessed.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2