406215634-10-17-2019-17-CC-MMUR-BH6U4V-20191021151547

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 406215634
Report Date: 10/17/2019
Date Signed: 10/17/2019 05:22:27 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/06/2019 and conducted by Evaluator Gigi Reyes

PUBLIC

COMPLAINT CONTROL NUMBER: 17-CC-20190806094939

FACILITY NAME:	HEARTS AND HANDS CHRISTIAN CHILDCARE & PS		FACILITY NUMBER:	406215634
ADMINISTRATOR:	DESTINY MORRIS		FACILITY TYPE:	850
ADDRESS:	112 ORCHARD ROAD		TELEPHONE:	(408) 748-3500
CITY:	NIPOMO	STATE: CA	ZIP CODE:	93444
CAPACITY:	60	CENSUS: 31	DATE:	10/17/2019
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Debra Patterson		TIME COMPLETED:	01:20 PM

ALLEGATION(S):

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Lack of supervision resulted in daycare child injury

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Gigi Reyes conducted an unannounced inspection to deliver the final findings on the complaint received on 8/6/2019. LPA met with new Center Director, Ms. Debra Patterson. There were 31 pre school children and 4 teachers present.

Regarding the allegation lack of supervision resulted in day care child injury, it was alleged that Child # 1 (C1) sustained bruising from a furniture falling on Child # 1 at day care. On 9/4/2019, LPA's interview with Teacher 1 revealed that the incident occurred on July 29, 2019, C1's first day at the preschool. On the said date at 8:00 AM, there were 6 children and 2 teachers present . C1 was walking, exploring and stopped by the Dress Up Island, stood on its base and hanged on it, it tilted and eventually fall on C1. Teacher 2 witnessed the whole incident however, teacher 2 was not able to prevent the Dress Up Island from falling. C1 sustained a laceration on C1's chin. Medical Report stated that C1 sustained laceration on C1's chin and was glued. LPA observed the said furniture was moved and placed against the wall to prevent similar incident from happening.
Continued on 9099 C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

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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Control Number 17-CC-20190806094939

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 6500 HOLLISTER AVE., SUITE 200
GOLETA, CA 93117

FACILITY NAME: HEARTS AND HANDS CHRISTIAN CHILDCARE & PS	FACILITY NUMBER: 406215634
	VISIT DATE: 10/17/2019

NARRATIVE

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Investigation consists of interviews with teacher, parents of current and previously enrolled day care children and video footage of the incident. Seven (7) out of 7 parents interviewed did not corroborate with the allegations. Parents have no concern with regards to care and supervision.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

LPA observed Director Notice of Site Visit.

SUPERVISOR'S NAME: Maria Mueller	TELEPHONE: (805) 562-0410
LICENSING EVALUATOR NAME: Gigi Reyes	TELEPHONE: (805) 698-7114
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC9099 (FAS) - (06/04)

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