343623767-3-3-2021-03-CC-KPES-C2QS6Q-20210505133614

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343623767
Report Date: 03/01/2021
Date Signed: 03/03/2021 08:57:56 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
02/19/2021 and conducted by Evaluator Rosie Pitts

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20210219084835

FACILITY NAME:	PARKER, MARK		FACILITY NUMBER:	343623767
ADMINISTRATOR:	PARKER, MARK		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(219) 384-1228
CITY:	FAIR OAKS	STATE: CA	ZIP CODE:	95628
CAPACITY:	14	CENSUS: 6	DATE:	03/01/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Mark Parker		TIME COMPLETED:	11:00 AM

ALLEGATION(S):

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Other: Alterations to Existing Buildings or Grounds

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Rosie Pitts contacted Licensee regarding the complaint allegation mentioned above. Due to COVID-19 pandemic, LPA is conducting the meeting via FaceTime. Licensee's daughter, Natalia Boyko, as well as Licensee's assistant, Liudmyla, was also present during the inspection. LPA was unable to conduct the visit until Licensee's daughter arrived to the facility. During the Facetime visit, LPA Pitts requested a tour of the facility, and conducted interviews. LPA observed 6 children being supervised and asked for each child's name.
On 02/19/2021, the department received a complaint alleging that construction was being done in the backyard without notifying Licensing. LPA observed a newly installed wooden fence in the backyard. Licensee stated that he does not remember when the fence was built, but that it was built after he was Licensed. Natalia stated that the fence was built last weekend for more protection for the daycare children.
Report continued on 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2021

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-20210219084835

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: PARKER, MARK	FACILITY NUMBER: 343623767
	VISIT DATE: 03/01/2021

NARRATIVE

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Licensee inspected the area during Facetime and ensured that the area was free of debris and hazardous items. The fence appeared to be sturdy and in good condition. Photos were taken. Based on observations and interviews, the allegation of alterations to existing building grounds is substantiated and cited on LIC 9099-D.
LPA discussed inspection authority and unannounced visits. Appeal rights were discussed and a copy was provided to the Licensee. In lieu of Licensee's signature, LPA Pitts is e-mailing the report and Licensee will respond via email as verification of receipt.

SUPERVISOR'S NAME: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2021

LIC9099 (FAS) - (06/04)

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Control Number 03-CC-20210219084835

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: PARKER, MARK	FACILITY NUMBER: 343623767
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/01/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 03/31/2021 Section Cited CCR 102416.3(a)	1 2 3 4 5 6 7	(a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed...	1 2 3 4 5 6 7	LPA observed the fence on Facetime and did not observe and debris or hazardous items. Licensee stated that Licensing will be notified of any other alterations made to the home before they are made.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: LPA observed a wooden fence installed in the backyard.Licensee's daughter stated that the previous fence was a metal gate with openings, and the wooden fence was built for more protection	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: Maria Mayorga	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Rosie Pitts	TELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:	DATE: 03/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2021

LIC9099 (FAS) - (06/04)

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