343619199-10-22-2021-03-CC-RSAA-C89KW4-20211029081519

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343619199
Report Date: 10/22/2021
Date Signed: 10/22/2021 01:52:18 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
10/04/2021 and conducted by Evaluator Christopher Bello

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20211004122422

FACILITY NAME:	GUERIN, DEANIE		FACILITY NUMBER:	343619199
ADMINISTRATOR:	GUERIN, DEANIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(916) 395-1916
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95831
CAPACITY:	14	CENSUS: 6	DATE:	10/22/2021
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Deanie Guerin		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Staff did not ensure that medication is stored locked and inaccessible to children in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 12:30pm and met with licensee Deanie Guerin to close the complaint investigation regarding the above allegation. Upon arrival, LPA observed six children. Also present was licensee’s daughter. LPA made observations, gathered documents pertaining to the investigation and conducted interviews with staff. It was alleged that the licensee did not properly store medication causing a child to get a hold of teething tablets spilling the medication all over the floor in reach of other children. The licensee admitted to the incident occurring. Deanie stated that it was an accident and that she thought that she tightened the lid to the teething tablets down before she placed the bottle down. Deanie also stated that she placed the bottle down just for a second to answer the door for a parent during pickup and usually keeps her medicine up high in a cabinet. Based on LPAs' investigation the preponderance of evidence standard has been met therefore the above allegations are found to be substantiated. Title 22 deficiencies are cited on the subsequent page of this report. Type Acknowledgement forms are to be signed by current parent of the facility and new parents for the next twelve months. LIC 9224 and Appeal Rights were provided. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the licensee.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

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-20211004122422

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: GUERIN, DEANIE	FACILITY NUMBER: 343619199
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/22/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 10/22/2021 Section Cited CCR 102417(g)(4)	1 2 3 4 5 6 7	Poisons, detergents, cleaning compounds, medicines, firearms and other items which could pose a danger if readily available to children shall be stored where they are inaccessible to children. This requirement has not been met by evidence: Licensee left a bottle on the table allowing a daycare	1 2 3 4 5 6 7	Deanie stated that the incident was an accident and that she thought it the bottle was full closed when she placed it down. LPA cleared the deficiency and gave the licensee a copy of the clearance letter.
	8 9 10 11 12 13 14	child access to it. This is considered as an immediate risk to the 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: Roxana Saravia	TELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Christopher Bello	TELEPHONE: (916) 862-0844
LICENSING EVALUATOR SIGNATURE:	DATE: 10/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/22/2021

LIC9099 (FAS) - (06/04)

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