343622006-7-12-2022-03-CC-SDLA-CGRJQY-20220728071553

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343622006
Report Date: 07/12/2022
Date Signed: 07/12/2022 02:07:56 PM

Substantiated

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
05/23/2022 and conducted by Evaluator Karyn Guerra

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220523121433

FACILITY NAME:	APPLE A DAY PRESCHOOL & INFANT CTR (PS)		FACILITY NUMBER:	343622006
ADMINISTRATOR:	FARFAN, LILIYA		FACILITY TYPE:	850
ADDRESS:	5013 EL CAMINO AVE		TELEPHONE:	(916) 481-5400
CITY:	CARMICHAEL	STATE: CA	ZIP CODE:	95608
CAPACITY:	36	CENSUS: 15	DATE:	07/12/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Liliya Farfan		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Staff did not provide adequate supervision.

INVESTIGATION FINDINGS:

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At 10:15 a.m. on Tuesday, July 12th. 2022, Licensing Program Analyst (LPA) Karyn Guerra met with Director, Lilya Farfan, for the purpose of an unannounced complaint inspection. It was alleged that staff did not provide adequate supervision. There was a concern that children engaged in inappropriate behavior. Throughout the course of the investigation, LPA conducted interviews and made observations. The facility self reported an incident brought to their attention by a parent on 5/13/2022. Director stated during interview that children were observed playing "baby" imaginary play regarding labor and delivery. While LPA could not determine if there was a lack of supervision when the incident occurred, LPA observed staffing and supervision concerns throughout the course of the investigation. During today's inspection, LPA observed Staff 1 (S1) alone with 13 children in care outside at 10:25 a.m. and 10:52 a.m., while Staff 2 (S2) was assisting

Report continued on 9099-C.

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: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

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-20220523121433

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: APPLE A DAY PRESCHOOL & INFANT CTR (PS)	FACILITY NUMBER: 343622006
	VISIT DATE: 07/12/2022

NARRATIVE

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children with the restroom indoors. At 10:32 a.m., 2 children were observed indoors. 1 child was with S2, getting a diaper change. The second child was observed in the classroom area. S2 did not have visual supervision of the child in the classroom. Child opened the door to the play yard. At 10:56 a.m., during observation of outdoor play, LPA observed a child open the side gate and enter into the infant play yard with another child. Children ran to the play house in the back and sat down. Play house was around the corner from view of S1, who was alone in the preschool play yard. S1 did not have visual supervision of the two children. LPA alerted S1 of the two children who were in the infant play yard, and S1 retrieved the children. The preponderance of evidence standard has been met, and the allegation is substantiated.

Title 22 deficiencies are cited on the subsequent pages of this report. Director acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days for parental review.

SUPERVISOR'S NAME: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20220523121433

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: APPLE A DAY PRESCHOOL & INFANT CTR (PS)	FACILITY NUMBER: 343622006
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/12/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/13/2022 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation. This requirement was not met, as evidenced by:	1 2 3 4 5 6 7	Director will conduct a training with staff and will provide documentation to LPA by POC due date.
	8 9 10 11 12 13 14	Based on observation, facility did not provide adequate visual supervision to children in care. This poses an immediate risk to the health and safety of 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: Seychelle De Luca	TELEPHONE: (916) 263-5719
LICENSING EVALUATOR NAME: Karyn Guerra	TELEPHONE: (916) 216-7790
LICENSING EVALUATOR SIGNATURE:	DATE: 07/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2022

LIC9099 (FAS) - (06/04)

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