430709449-5-15-2019-07-CC-ASTR-BCERVW-20190522132213

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 430709449
Report Date: 05/15/2019
Date Signed: 05/15/2019 11:04:41 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/13/2019 and conducted by Evaluator Samantha Yip

PUBLIC

COMPLAINT CONTROL NUMBER: 07-CC-20190513165050

FACILITY NAME:	MORGAN HILL PARENT-CHILD NURSERY SCHOOL		FACILITY NUMBER:	430709449
ADMINISTRATOR:	JULIE PERRY		FACILITY TYPE:	850
ADDRESS:	16870 MURPHY AVENUE		TELEPHONE:	(408) 779-4515
CITY:	MORGAN HILL	STATE: CA	ZIP CODE:	95037
CAPACITY:	24	CENSUS: 12	DATE:	05/15/2019
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Jessica Mason		TIME COMPLETED:	11:10 AM

ALLEGATION(S):

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Unsafe play equipment.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Samantha Yip and Licensing Program Manager (LPM) Tony Studebaker conducted an initial 10 day complainant inspection for the above allegation. LPA and LPM met with Ms. Natasha Vanscoter Ramrez and explained the reason for the inspection. Director Jessica Mason arrived shortly after.

During the inspection, LPA and LPM inspected the play structure outside and interviewed Director Jessica. Director Jessica stated that the center tied a rope on the play structure above the slide for the children to climb up. The rope added was not part of manufacture's original design and was arranged where it conflicted with children sliding down, which

----continues on 9099 dated 05/15/2019 pg. 2-----

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

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 07-CC-20190513165050

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MORGAN HILL PARENT-CHILD NURSERY SCHOOL	FACILITY NUMBER: 430709449
	VISIT DATE: 05/15/2019

NARRATIVE

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poses a risk to the children in care. LPA and LPM observed that the rope was not on play structure during the inspection. Director Jessica stated that the president of the board took the rope down on 05/10/2019. Therefore, the above allegation is SUBSTANTIATED meaning the allegation is valid because the preponderance of the evidence standard has been met.

LPM discussed with Director Jessica about checking with Licensing and the manufacture guidelines before any additions are being added to play structures. LPM informed Director Jessica about Consumer Product Safety Commission website: cpsc.gov, where she can find information about playground equipment for day care centers.

As a result of today's inspection, a Type B citation has been cited. An exit interview were this report, the deficiency, plan of correction, and appeal rights, were discussed and provided to Director Jessica. Director Jessica stated that they will not be placing the rope back up; therefore, the risk to children has been eliminated. Deficiency has been corrected.

A notice of site visit has been issued and must be posted for 30 consecutive days.

SUPERVISOR'S NAME: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 07-CC-20190513165050

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: MORGAN HILL PARENT-CHILD NURSERY SCHOOL	FACILITY NUMBER: 430709449
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/15/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/22/2019 Section Cited CCR 101238.2(c)	1 2 3 4 5 6 7	Outdoor Activity Space. Equipment and activity areas shall be arranged so that there is no hazard from conflicting activities. This requirement is not met as evident by:	1 2 3 4 5 6 7	The president of the board removed rope from play structure on 05/10/2019. Director Jessica confirmed that rope will not be placed back on play structure.
	8 9 10 11 12 13 14	Based on interview, Licensee failed to ensure that the rope added to the play structure was part of the original manufacture design. Licensee also failed to ensure that the rope did not conflict with children sliding down. This poses a potential risk to the health and safety of the children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Anthony Studebaker	TELEPHONE: (408) 324-2148
LICENSING EVALUATOR NAME: Samantha Yip	TELEPHONE: (408) 529-8128
LICENSING EVALUATOR SIGNATURE:	DATE: 05/15/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/15/2019

LIC9099 (FAS) - (06/04)

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