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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343621637
Report Date: 02/05/2025
Date Signed: 02/05/2025 11:08:43 AM

Unsubstantiated


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
10/10/2024 and conducted by Evaluator Fabian Schwartz
COMPLAINT CONTROL NUMBER: 03-CC-20241010111505
FACILITY NAME:PIERCE, TIFFANYFACILITY NUMBER:
343621637
ADMINISTRATOR:PIERCE, TIFFANYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 743-0397
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY:14CENSUS: 7DATE:
02/05/2025
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tiffany PierceTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Personal Rights - Child sustained burns while in care - Unsubstantiated
INVESTIGATION FINDINGS:
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On Wednesday, 5 January 2025, at approximately 9:30am Licensing Program Analyst (LPA) Fabian Schwartz met with licensee Tiffany Pierce to deliver the findings of a complaint investigation. At time of inspection, Licensee was supervising 7 children. Also present at time of inspection were Licensee’s two assistants.

On 10 October 2024, LPA Schwartz was assigned complaint which alleged a child had sustained a burn while in care. On 15 October 2024, LPA Schwartz opened complaint with Licensee. The complaint was assigned to the Department's Investigation's Branch (IB). During investigation, LPA and IB investigator made observations, gathered documents, and conducted interviews with parents, staff, and Licensee. Licensee provided photographic evidence which is contradictory to allegation. IB investigation concluded that allegations are unsubstantiated by investigation into complaint.

Report Continued on LIC-9099-C..........
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Fabian SchwartzTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
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-20241010111505
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: PIERCE, TIFFANY
FACILITY NUMBER: 343621637
VISIT DATE: 02/05/2025
NARRATIVE
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Report Continued from LIC-9099.....


Although the allegation may have happened, there is not a preponderance of evidence to prove the allegation; therefore, the allegation is unsubstantiated.

Exit interview was conducted and report was reviewed with Licensee. Appeal rights were provided. Notice of site visit was given and must remain posted for 30 days.
SUPERVISOR'S NAME: Amanda BlesiTELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Fabian SchwartzTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2