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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343615376
Report Date: 11/08/2019
Date Signed: 11/08/2019 09:42:39 AM



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
11/05/2019 and conducted by Evaluator Karyn Guerra
COMPLAINT CONTROL NUMBER: 03-CC-20191105144249
FACILITY NAME:WEE TYMES PLAYSCHOOLFACILITY NUMBER:
343615376
ADMINISTRATOR:INGALLS, DANELLEFACILITY TYPE:
850
ADDRESS:2925 ROOT AVENUETELEPHONE:
(916) 487-8411
CITY:CARMICHAELSTATE: CAZIP CODE:
95608
CAPACITY:30CENSUS: DATE:
11/08/2019
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Phyllis BarnsdaleTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Facility has unsafe equipment resulting in child sustaining an injury
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Karyn Guerra conducted an unannounced complaint inspection. The purpose of the visit was explained. During the inspection, LPA made observations, interviews, and gathered documentation. Interviews with staff, and reports received, confirmed that child had been injured on scooter. LPA observed 2 scooters in the sandbox area of play yard that is currently closed to prevent access to children. Neither scooter had handle bar covers, leaving metal handle bars exposed. This is a potential risk to children in care.Based on LPA's observations and interviews, the preponderance of evidence standard has been met, therefore, the above allegation is found to be SUBSTANTIATED.

Deficiencies are cited on the subsequent page of this report under the California Code of Regulations, Title 22. Staff was provided a copy of the Appeal Rights (LIC9058) and Staff's signature on this form acknowledges receipt of these rights.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
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-20191105144249
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: WEE TYMES PLAYSCHOOL
FACILITY NUMBER: 343615376
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/09/2019
Section Cited
CCR
101239(n)
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101239 Fixtures, Furniture, Equipment and Supplies
(n) Furniture and equipment shall be maintained in good condition, free of sharp, loose or pointed parts. This requirement was not met, as evidenced by:
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Staff stated that facility will either dispose of scooters or fix handle bars by covering with a cushioned material by POC due date.
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LPA observed 2 scooters in the sand box area missing handle bar covers. This is a potential risk to children in care.
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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.
SUPERVISOR'S NAME: Keven PetersTELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn GuerraTELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2019
LIC9099 (FAS) - (06/04)
Page: 2 of 2