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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 390320654
Report Date: 12/09/2021
Date Signed: 12/09/2021 02:14:15 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
12/03/2021 and conducted by Evaluator Christopher Jackson
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20211203132516
FACILITY NAME:ST. ANTHONY'S PRESCHOOLFACILITY NUMBER:
390320654
ADMINISTRATOR:DALEN, JENNIFERFACILITY TYPE:
850
ADDRESS:323 N. FREMONT AVENUETELEPHONE:
(209) 823-3959
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:56CENSUS: 31DATE:
12/09/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jennifer DalenTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Unqualified staff providing care and supervision to children
INVESTIGATION FINDINGS:
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On 12/09/21 Licensing Program Analysts (LPAs) Christopher Jackson and Chayntel Hunter met with Director Jennifer Dalen to open and close a complaint investigation regarding the allegation “Unqualified staff providing care and supervision to children."
During the investigation, LPAs Jackson and Hunter conducted interviews, and obtained information pertinent to the allegation. It was revealed that a volunteer in the program is left alone to supervise the napping preschool children for a duration of time. In addition LPAs learned the volunteer is utilized as part of the centers staffing plan, by supporting breaks for the qualified staff on site. The director stated they misunderstood the difference between an aide and volunteer when utilizing the permanent volunteer within the progarm.
Based on the information obtained during the investigation the evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The following Title 22 Deficiency is being cited on the subsequent 9099-D page. Upon receipt of Type A citations, Director shall post and provide copies of the LIC 9099-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 9099-D in each child's file. Appeal Rights and Notice of Site Visit were provided.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
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 3
Control Number 53-CC-20211203132516
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: ST. ANTHONY'S PRESCHOOL
FACILITY NUMBER: 390320654
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/10/2021
Section Cited
CCR
101216(c)
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Personnel Requirements 101216(c) . The licensee may utilize volunteers provided that such volunteers are supervised and are not included in the center's staffing plan. This regulation was not met as evidenced by,
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The director stated that she will remain in the room with the volunteer during nap time.
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Based on interviews conducted and records reviewed, it was determined the facility utilized a volunteer for staffing purposes and was left alone without being under the direct supervision of a fully qualified staff person. This poses an immediate health and safety risk to children in care.
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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: Justin L DentonTELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
12/03/2021 and conducted by Evaluator Christopher Jackson
COMPLAINT CONTROL NUMBER: 53-CC-20211203132516

FACILITY NAME:ST. ANTHONY'S PRESCHOOLFACILITY NUMBER:
390320654
ADMINISTRATOR:DALEN, JENNIFERFACILITY TYPE:
850
ADDRESS:323 N. FREMONT AVENUETELEPHONE:
(209) 823-3959
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:56CENSUS: 31DATE:
12/09/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jennifer DalenTIME COMPLETED:
02:30 PM
ALLEGATION(S):
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2
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5
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9
Children unattended in bathroom
INVESTIGATION FINDINGS:
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On 12/09/21 Licensing Program Analysts (LPAs) Christopher Jackson and Chayntel Hunter met with Director Jennifer Dalen to open and close a complaint investigation regarding the allegation “Children unattended in bathroom."
During the investigation, LPAs Jackson and Hunter conducted interviews, and obtained information pertinent to allegation. In addition, LPAs conducted observations of the classroom. LPAs observed the bathroom to have a half door, allowing for staff to visually observe children, and allows children to be accesible to staff if support is needed. In addiotion, LPAs observed that staff postion themselves in the area of the restroom to support if needed. Intervviews revelaed staff will multi-task while supervising the children in the restroom, and will guide children if they need assistance while in the bathroom.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the finding is UNSUBSTANTIATED.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Justin L DentonTELEPHONE: (916) 926-0269
LICENSING EVALUATOR NAME: Christopher JacksonTELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3