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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393614120
Report Date: 09/29/2022
Date Signed: 09/29/2022 12:10:38 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 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
09/23/2022 and conducted by Evaluator Lauren Scott
COMPLAINT CONTROL NUMBER: 53-CC-20220923171144
FACILITY NAME:REFUGE CHRISTIAN PRESCHOOL & KINDERGARTENFACILITY NUMBER:
393614120
ADMINISTRATOR:LORI SHERMANFACILITY TYPE:
850
ADDRESS:486 BUTTON AVETELEPHONE:
(209) 825-1095
CITY:MANTECASTATE: CAZIP CODE:
95336
CAPACITY:120CENSUS: 49DATE:
09/29/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:director, Lori ShermanTIME COMPLETED:
12:21 PM
ALLEGATION(S):
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Staff did not change child's diaper as often as needed.
Staff did not wash their own hands after each diaper change.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Lauren Scott and Mariya Melnichuk met with Director, Lori Sherman to deliver the findings of the complaint investigation regarding the above allegation.

During the course of the investigation, LPA Scott conducted interviews, and obtained information pertaining to allegation. LPA Scott was able to view video surveilalance of the incident that ocurred. It was alleged that children's diapers were not being changed consistently throughout the day. It was also alleged that staff were not washing their hands in between or after diaper changing, nor were they wearing gloves. The video surveillance of September 19, 2022 showed evidence that C1 was not changed in a timely manner.

Report continues on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren ScottTELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
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-20220923171144
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: REFUGE CHRISTIAN PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 393614120
VISIT DATE: 09/29/2022
NARRATIVE
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Based on the interviews and LPA observations of video surveillance, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. Title 22 regulations are being cited on the attached 9099-D page.

An exit interview was conducted with the Director. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren ScottTELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20220923171144
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: REFUGE CHRISTIAN PRESCHOOL & KINDERGARTEN
FACILITY NUMBER: 393614120
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/29/2022
Section Cited
CCR
101223(a)(3)
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(a) The licensee shall ensure that each child is accorded the following personal rights:(3) To be free from... but not limited to: interference with functions of daily living including... toileting; ...aids to physical functioning. This requirement was not met as evidenced by:
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The facility began implementing a diaper changing log on 9/26/22, as well as using alarms in the Brightwheel application for every 30-45 minutes to signal teachers it is time for diaper changes. Director will also add this implementation to the parent handbook
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On 9/19/22 video evidence revealed that C1 did not have a diaper change for approximately 5 hours. The video also showed the teacher's failure to wash hands in between or after diaper changes. This is a potential 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: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren ScottTELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:

DATE: 09/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/29/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3