343620505-10-15-2021-03-CC-SDLA-C85MBG-20211025092751

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343620505
Report Date: 10/14/2021
Date Signed: 10/15/2021 08:48:57 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
09/01/2021 and conducted by Evaluator Karyn Guerra

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210901114642

FACILITY NAME:	TOTS OF LOVE		FACILITY NUMBER:	343620505
ADMINISTRATOR:	VANESSA GRANT		FACILITY TYPE:	850
ADDRESS:	5619 MARCONI AVENUE		TELEPHONE:	(916) 689-8687
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	24	CENSUS: 7	DATE:	10/14/2021
		UNANNOUNCED	TIME BEGAN:	02:45 PM
MET WITH:	Valyncia Johnson		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Facility failed to report change of Director in a timely manner.

INVESTIGATION FINDINGS:

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At 2:45 p.m. on Thursday, October 14th, 2021, Licensing Program Analyst (LPA) Karyn Guerra, met with Director, Valyncia Johnson, for the purpose of a complaint inspection to deliver findings. It was alleged that facility failed to report a change of Director in a timely manner. Throughout the course of the investigation, LPA conducted interviews and requested documents. LPA learned that previous Director has not been at the facility since May of 2021. Licensing Program Manager (LPM) Seychelle De Luca provided director checklist and requested paperwork from new Director on June 16th, 2021. Facility was reminded to submit paperwork during a previous inspection. The department did not receive paperwork to qualify new director in the required timeframe. The preponderance of evidence standard has been met, and the allegation is substantiated. A Title 22 deficiency is cited on the subsequent page of this report. Appeal rights and a notice of site visit were provided. Notice of site visit shall remain posted for a period of 30 days for parental review.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

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-20210901114642

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: TOTS OF LOVE	FACILITY NUMBER: 343620505
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/14/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 11/15/2021 Section Cited CCR 101212(b)(1)	1 2 3 4 5 6 7	Reporting Requirements (b) The name of the child care center director....shall be reported to the Department within 10 days of a change...(1)...the report shall include the following: Verification of the completion of the course work required in Section 101215.1(h)...a summary of experience... This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	Director will follow up with LPA and provide required documents for qualification.
	8 9 10 11 12 13 14	Based on interviews and documentation, the facility did not provide required qualifying documents for director change.	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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 10/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021

LIC9099 (FAS) - (06/04)

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