490100475-6-21-2019-01-CC-AHON-BDGJTV-20190625072033

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 490100475
Report Date: 06/20/2019
Date Signed: 06/21/2019 09:20:28 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/25/2019 and conducted by Evaluator Yang Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20190425082601

FACILITY NAME:	CROSS & CROWN LUTHERAN PRESCHOOL		FACILITY NUMBER:	490100475
ADMINISTRATOR:	MC CARTHY, MANDY		FACILITY TYPE:	850
ADDRESS:	5474 SNYDER LANE		TELEPHONE:	(707) 795-7863
CITY:	ROHNERT PARK	STATE: CA	ZIP CODE:	94928
CAPACITY:	70	CENSUS: 11	DATE:	06/20/2019
		UNANNOUNCED	TIME BEGAN:	01:19 PM
MET WITH:	Mandy McCarthy		TIME COMPLETED:	04:48 PM

ALLEGATION(S):

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Lack of supervision resulting in day care child sustaining injury.

INVESTIGATION FINDINGS:

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A follow-up unannounced complaint investigation inspection was made to the facility by Licensing Program Analyst (LPA) Y. Yang. It has been alleged that there is a lack of supervision resulting in a day care child sustaining injury. Specifically, that on 02/26/19 and 03/07/19 child C1 was bit by another child and on 03/05/19, child C1 was scratched on the face by another child during dance, and on 04/27/19, child C1 may have either been struck on the head with a musical instrument or bit on their head by another child.

On 04/30/19 at 02:05pm, LPA met with center director Mandy McCarthy (S1) to discuss the allegation. McCarthy stated that she denies the allegation but acknowledged that C1 did sustain minor injuries or scratches while in care but that the injuries were not due to a lack of supervision. McCarthy stated that children in care are always supervised by at least one adult staff member.

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019

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 01-CC-20190425082601

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: CROSS & CROWN LUTHERAN PRESCHOOL	FACILITY NUMBER: 490100475
	VISIT DATE: 06/20/2019

NARRATIVE

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On 04/30/19, LPA conducted interviews with staff S1-S4 at the center beginning at 01:45pm. Telephone interviews were conducted with S5 and S6 on 06/12/19 beginning at 02:24pm. Interviews with staff corroborated that on 03/07/19 child C1 was bit on the back by another child but this incident was not due to a lack of supervision. Staff also corroborated that child C1 was scratched on the cheek during a dance activity on 03/05/19 and struck on the back of the head by a musical instrument on 04/27/19. Staff members interviewed stated that these two incidents were due to an accident rather than a lack of supervision.

During the course of the investigation, interviews with child care clients and children were also conducted. LPA was unable to obtain corroborating information to suggest that there is a lack of supervision at the center resulting in day care children receiving injuries.

During unannounced inspection visits to the facility, LPA observed eleven children being supervised by three staff members on 04/30/19 and on 06/20/19, LPA observed eleven children being supervised by four staff members. During both inspection visits, LPA observed staff members observing and interacting with children both inside the classroom and outside on the playground. LPA did not observe any distracted teachers or staff members. No children were observed to be left without supervision of a staff member.

Although it was corroborated that child C1 sustained minor injuries while in care, there was not sufficient evidence obtained to substantiate that said child's injuries resulted due to a lack of supervision or any other deficiency of Title 22 Regulations. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, therefore the allegation is unsubstantiated. Appeal rights were provided. Notice of site visit must be posted for 30 days from today's inspection

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 06/20/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/20/2019

LIC9099 (FAS) - (06/04)

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