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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393602276
Report Date: 03/01/2023
Date Signed: 03/01/2023 03:55:01 PM

Unsubstantiated


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
12/13/2022 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20221213102852
FACILITY NAME:CARLSON, SARAHFACILITY NUMBER:
393602276
ADMINISTRATOR:CARLSON, SARAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 298-9554
CITY:STOCKTONSTATE: CAZIP CODE:
95209
CAPACITY:14CENSUS: 10DATE:
03/01/2023
UNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Sarah CarlsonTIME COMPLETED:
04:05 PM
ALLEGATION(S):
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Personal Rights-Provider did not ensure children are transported in a safe manner
INVESTIGATION FINDINGS:
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On 03/01/23, Licensing Program Analysts (LPA) Elvira Sierra met with the licensee, Sarah Carlson to continue and conclude the investigation as well as to deliver findings regarding the above allegation. LPA conducted interviews and made observations of the facility. Upon arrival LPA toured the facility, todays census was 10 school age children.

LPA received conflicting information from interviews. The complainant states Staff #1 did not ensure children are transported in a safe manner by not following road safety rules. Interviews with staff and children indicate that Staff # 1 obey all traffic signs, signals and roadway markings. Also, staff disclosed that facility follows child passenger safety recommendation by using the appropriate restrain system according to child age, height and weight. Children that were interviewed disclosed never feeling unsafe while being transported by Staff #1. Parents that were interviewed disclosed to have no concerns regarding the transportation of the children.
Report continues on subsuquent page 809C--
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
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 53-CC-20221213102852
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: CARLSON, SARAH
FACILITY NUMBER: 393602276
VISIT DATE: 03/01/2023
NARRATIVE
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Based on interviews, and observations; 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 allegation is unsubstantiated.

An Exit Interview was conducted in which the report and Appeal of Rights were discussed and provided to Licensee, Sarah Carlson. Notice of Site Visit was posted and should remain poster for 30 days.
SUPERVISOR'S NAME: Bettina EngelmanTELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira SierraTELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2