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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343616543
Report Date: 07/21/2023
Date Signed: 07/21/2023 11:28:14 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/10/2023 and conducted by Evaluator Karyn Guerra
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230510132113
FACILITY NAME:SAN JUAN PRE-SCHOOLFACILITY NUMBER:
343616543
ADMINISTRATOR:LEWIS, JENNYFACILITY TYPE:
830
ADDRESS:7413 WISCONSIN DRIVETELEPHONE:
(916) 863-0337
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:12CENSUS: 7DATE:
07/21/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jenny LewisTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Staff did not move sleeping infants to crib as soon as possible.
INVESTIGATION FINDINGS:
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At 10:00 a.m. on Friday, July 21st, 2023, Licensing Program Analysts (LPAs) Karyn Guerra and Pa Dao Vang met with Director, Jenny Lewis, for the purpose of an unannounced complaint inspection to deliver findings. LPAs observed a census of 7 infants supervised by 3 staff. 1 infant child was napping in the crib area during tour of facility. It was alleged that staff did not move sleeping infants to cribs as soon as possible. There was a concern of infants observed sleeping in a swing and "Bumbo" floor chair for an estimated period of up to 25 to 30 minutes. Throughout the course of the investigation, LPA Guerra conducted interviews and made observations. Parent interviews did not reveal any concerns. LPA came to learn from Staff that there was an incident in which a child (C1) was found napping in a Bumbo floor chair. Staff stated that the time C1 was napping in the Bumbo chair was not fully known, but it was

report continued on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
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 3
Control Number 03-CC-20230510132113
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: SAN JUAN PRE-SCHOOL
FACILITY NUMBER: 343616543
VISIT DATE: 07/21/2023
NARRATIVE
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estimated to be for a period of a couple of minutes to 5 minutes. Staff stated that there was a staff member initially sitting with the child at the Bumbo chair, and then they conducted a facility tour, during which time it was brought to their attention that C1 was napping in the Bumbo chair. Staff stated that C1 was then were transferred to a crib. LPA confirmed that the parent/guardian of C1 was informed of the incident. The preponderance of evidence standard has been met, and the allegation is substantiated. LPA reviewed supervision requirements with Director, and reminded that supervision shall include visual observation. LPA also discussed teacher-child ratio and reminded Director that a teacher shall not be required to perform housekeeping or maintenance duties that prevent him/her from performing duties related to providing care and supervision to children.

Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director, Jenny Lewis. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20230510132113
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: SAN JUAN PRE-SCHOOL
FACILITY NUMBER: 343616543
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2023
Section Cited
CCR
101430(a)(3)(E)
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101430 Infant Care Activities (E) If an infant falls asleep before being placed in a crib, staff shall move the infant to a crib as soon as possible. This requirement was not met, as evidenced by:
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Director will provide documentation of safe sleep training to LPA by POC due date.
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Based on interview, the facility did not comply with the above regulation as it was learned that an infant slept for an unknown amount of time estimated to be a couple of minutes to 5 minutes in a "Bumbo" chair before being transferred to a crib. This poses an immediate risk to the health and safety of 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.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3