393620521-12-17-2019-53-CC-SOGO-BK5RL6-20191223120635

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393620521
Report Date: 12/17/2019
Date Signed: 12/17/2019 02:11:24 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
11/27/2019 and conducted by Evaluator Charlotte Baney

COMPLAINT CONTROL NUMBER: 53-CC-20191127124055

FACILITY NAME:	CREATIVE CHILD CARE INC @ MICHIGAN HEIGHTS CHURCH		FACILITY NUMBER:	393620521
ADMINISTRATOR:	SAVINA GAINES		FACILITY TYPE:	850
ADDRESS:	3156 MICHIGAN AVENUE		TELEPHONE:	(209) 941-9100
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95204
CAPACITY:	38	CENSUS: 5	DATE:	12/17/2019
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Veronica Gonzalez		TIME COMPLETED:	02:20 PM

ALLEGATION(S):

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Daycare child sustained multiple injuries while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPAs) Charlotte Baney and Gagandeep Singh met with Vernica Gonzalez to provide the finding for the above allegation. During the investigation LPA conducted interviews, made observations and reviewed information. The complainant alleged daycare child sustained multiple injuries while in care. Based on the conflicting information obtained throughout the course of this investigation the above allegation could not be substantiated or dismissed. Although the allegation may have happened (or is valid), there is not a preponderance of the evidence to prove the alleged violation did or did not occur, therefore the finding is UNSUBSTANTIATED.

Based on interviews, observations, documentation, and other information gathered, there was not a preponderance of evidence to prove or negate the allegation, therefore the allegation is unsubstantiated.
No Title 22 deficiencies were cited at time of visit. An exit interview was conducted in which the report was reviewed and discussed with director. Appeal rights were discussed, and a printed version was given to director.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Charlotte Baney	TELEPHONE: (916) 216-7791
LICENSING EVALUATOR SIGNATURE:	DATE: 12/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/17/2019

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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