343621911-5-25-2021-53-CC-BENN-C3DKZ9-20210526082021

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343621911
Report Date: 05/25/2021
Date Signed: 05/25/2021 04:48:53 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
03/02/2021 and conducted by Evaluator Stacey Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20210302094348

FACILITY NAME:	MOORE LEARNING PRESCHOOL & DCC (INF)		FACILITY NUMBER:	343621911
ADMINISTRATOR:	MOORE, FRISHA		FACILITY TYPE:	830
ADDRESS:	8699 ELK GROVE BLVD		TELEPHONE:	(916) 405-0448
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	20	CENSUS: 5	DATE:	05/25/2021
		UNANNOUNCED	TIME BEGAN:	01:49 PM
MET WITH:	Frisha Moore		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained injuries while in care
Facility staff are commingling children

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Due to the COVID-19 pandemic, Licensing Program Analyst (LPA) Stacey Williams conducted a Tele-Visit via FaceTime with Licensee, Frisha Moore in lieu of conducting an on site inspection regarding the above complaint allegations. There were 5 children supervised by 2 staff at the time of the inspection.

LPA Williams conducted interviews with the complainant, facility staff, parents and a child (C2). Facility records, medical records and photos were gathered to assist with the investigation. It was alleged that Child#1(C1) was injured while on a playground that was not associated to their classroom. LPA learned that C1 was in the process of transitioning into the next age level classroom and was playing on the visiting room’s play structure. Although the facility was within ratio when the incident occurred, C1’s personal rights were violated when staff allowed C1 to use the play structure not appropriate for C1’s age and developmental level, leading to injuries that warranted medical attention.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

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 4

Control Number 53-CC-20210302094348

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: MOORE LEARNING PRESCHOOL & DCC (INF)	FACILITY NUMBER: 343621911
	VISIT DATE: 05/25/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

It was alleged that facility commingles children of different ages. Interviews conducted revealed that while on the play structure, C1 intermingled with children from higher grade classrooms. The Director confirmed the facility does not have waiver on file for commingling of classrooms. There was also no documentation provided to support C1’s developmental level to visit the next grade level classroom.

Based on the evidence provided during the investigation, the allegations are determined to be substantiated.
Title 22 Deficiencies have been cited on the attached LIC 9099D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 9099D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, acknowledging receipt of Licensing Reports LIC 9099D in each child's files.

An exit interview was conducted, and a Plan of Correction was reviewed and developed with the Licensee. A copy of this report and appeal rights were discussed and left the Licensee, Frisha Moore, whose signature on this form confirm receipt of these documents. Notice of Site Visit was provided to Licensee to post during today’s inspection.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 53-CC-20210302094348

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: MOORE LEARNING PRESCHOOL & DCC (INF)	FACILITY NUMBER: 343621911
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/25/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 05/26/2021 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	The licensee shall ensure that each child is accorded the following personal rights: To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.	1 2 3 4 5 6 7	Prior to today's inspection Licensee made changes to the playground by removing the built in play structure. Licensee will provide photos of the play ground to CCL. Licensee will make an addendum to the "moving on up" form to include parent signature and notification of the transition process and areas of the center that
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: The facility failed to provide a safe environment for C1. As a result, C1 was running on a play structure that was not designated for their age level and sustained injuries. This is an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14	the child will visit. Photos of the playground and revised "moving on up " form will be submitted to Community Care Licensing by POC Date- 5/26/2021.
Type A 05/26/2021 Section Cited CCR 101161	1 2 3 4 5 6 7	A licensee shall not operate a childcare center beyond the conditions and limitations specified on the license, including the capacity limitation	1 2 3 4 5 6 7	Licensee will submit a waiver request to LPA Silva to allow for the commingling of children when needed by POC date- 5/26/21
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: C1 was playing on a visiting room’s play structure. While on the play structure, C1 intermingled with children from higher grade classrooms. This is an immediate risk to the health and safety of children in care.	8 9 10 11 12 13 14

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: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

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
03/02/2021 and conducted by Evaluator Stacey Williams

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20210302094348

FACILITY NAME:	MOORE LEARNING PRESCHOOL & DCC (INF)		FACILITY NUMBER:	343621911
ADMINISTRATOR:	MOORE, FRISHA		FACILITY TYPE:	830
ADDRESS:	8699 ELK GROVE BLVD		TELEPHONE:	(916) 405-0448
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	20	CENSUS:	DATE:	05/25/2021
		UNANNOUNCED	TIME BEGAN:	01:49 PM
MET WITH:	Frisha Moore		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee does not maintain an individualized feeding plan for infant

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Due to the COVID-19 pandemic, Licensing Program Analyst (LPA) Stacey Williams conducted a Tele-Visit via FaceTime with Licensee, Frisha Moore in lieu of conducting an on site inspection regarding the above complaint allegations. There were 5 children supervised by 2 staff at the time of the inspection.
LPA Williams conducted interviews with the complainant, facility staff, parents and a child (C2). Facility records, medical records and photos were gathered to assist with the investigation.
LPA reviewed children’s records to investigate the allegation that the licensee does not maintain an individualized feeding plan for an infant. Although the facility was not able to provide licensing with the Needs/Services plan, there was information on the child’s nutrition needs in the file. The Licensee did explain the facility was aware of the needs and accommodated C1 accordingly.
Based on the evidence provided during the investigation, the allegation is determined to be unsubstantiated.
An exit interview was conducted. A copy of this report and appeal rights were discussed and left the Licensee, Frisha Moore, whose signature on this form confirm receipt of these documents. Notice of Site Visit was provided to Licensee to post during today’s inspection.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Stacey Williams	TELEPHONE: (916) 216-7797
LICENSING EVALUATOR SIGNATURE:	DATE: 05/25/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/25/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 4