343618113-1-4-2021-03-CC-KPES-BX6NTM-20210111094455

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343618113
Report Date: 01/04/2021
Date Signed: 01/04/2021 04:11:20 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
08/12/2020 and conducted by Evaluator Karyn Guerra

COMPLAINT CONTROL NUMBER: 03-CC-20200812111656

FACILITY NAME:	BOYER, KIMBERLEY		FACILITY NUMBER:	343618113
ADMINISTRATOR:	BOYER, KIMBERLEY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 607-9300
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	14	CENSUS: 13	DATE:	01/04/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Kimberley Boyer		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Day care children are not being adequately supervised

Licensee used inappropriate forms of discipline

Licensee restrained child

Day care children are allowed in off limit areas

INVESTIGATION FINDINGS:

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At 2:00 p.m. on Monday, January 4th, 2021, Licensing Program Analyst (LPA) conducted a complaint inspection to follow up on the above allegations. A tele-inspection was conducted due to COVID-19. Census consisted of 13 children supervised by Licensee and assistant. During today's inspection, LPA conducted interviews, observations, and delivered findings. It was alleged that daycare children are not being adequately supervised. Licensee stated that they have an assistant to help supervise children, and at no time are children left at the facility without a CPR certified adult. It was alleged that Licensee used inappropriate forms of discipline. Licensee stated that typical discipline policy at the facility is redirection in addition to time out as a last resort. Interviews with staff and children confirmed the use of time out as a means of discipline. It was alleged that the Licensee restrained a child, referencing that a child was in a high chair for prologed periods of time.

Report continued on 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2021

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-20200812111656

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: BOYER, KIMBERLEY	FACILITY NUMBER: 343618113
	VISIT DATE: 01/04/2021

NARRATIVE

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Licensee stated that high chair at the facility is used for eating, and on occasion for activities, and is stored away when not in use. Interviews with staff and children confirmed that use of high chair is for eating. It was alleged that day care children are allowed in off limits areas. Staff and Licensee denied the allegation and LPA observed a gate used to separate the on limits areas of the facility from the off limits areas. Supervision is also used to prevent access to off limits areas. Children interviewed listed appropriate on limits areas of the home. The allegations are found to be unsubstantiated. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore, the allegations are unsubstantiated. This report will be delivered electronically via e-mail along with Notice of Site Visit and Appeal Rights. Acknowledgment of receipt of report will be documented in lieu of signature.

SUPERVISOR'S NAME: Keven Peters	TELEPHONE: (916) 216-7796
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 01/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/04/2021

LIC9099 (FAS) - (06/04)

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