393621067-2-23-2021-53-CC-JSMH-BYLMK9-20210226084020

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393621067
Report Date: 02/23/2021
Date Signed: 02/23/2021 11:52:30 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
12/10/2020 and conducted by Evaluator Christopher Jackson

COMPLAINT CONTROL NUMBER: 53-CC-20201210164142

FACILITY NAME:	CAP KERN EARLY HEAD START PROG - CHRISMAN		FACILITY NUMBER:	393621067
ADMINISTRATOR:	GLORIA MONTEZ		FACILITY TYPE:	830
ADDRESS:	23950 S CHRISMAN ROAD		TELEPHONE:	(209) 242-9540
CITY:	TRACY	STATE: CA	ZIP CODE:	95304
CAPACITY:	32	CENSUS: 12	DATE:	02/23/2021
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Gloria Montez		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Day care child got injured while in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Due to the COVID-19 pandemic Licensing Program Analyst (LPA), Christopher Jackson, conducted a virtual inspection with Gloria Montez, director. This visit was conducted via Google Duo, on 02/23/2021 at 11:20 am. The purpose of today's inspection is to provide the findings for a complaint investigation. The complaint alleged that “Day care child got injured while in care.” During the investigation process, LPA conducted interviews with various staff members and parents with children enrolled at the facility. In the interviews conducted with the staff it was disclosed that the staff were not aware of any children sustaining an injury as no child cried out or sought attention from the staff for support. It was also revealed in the staff interviews that the program has three teachers and one aide supervising up to eight infants. LPA also learned that an hour of time had lapsed from when the child was picked up from the facility to the time the injury was observed. In addition, interviews that were conducted with various parents provided no corroborating statements of supervision concerns.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

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 2

Control Number 53-CC-20201210164142

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: CAP KERN EARLY HEAD START PROG - CHRISMAN	FACILITY NUMBER: 393621067
	VISIT DATE: 02/23/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on the information obtained throughout the course of this investigation the above allegation could not be substantiated or dismissed. Although the allegations may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violations did or did not occur, therefore the findings are 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 Mrs. Montez. Appeal rights were discussed, and a printed version was emailed to the director. Notice of Site visit was provided. LPA provided the facility with a copy of this report via email on 02/23/2021. Mrs. Montez agreed to acknowledge receipt of the email, which will serve in lieu of a signature on this report.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Christopher Jackson	TELEPHONE: (916) 216-8837
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2