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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 503908423
Report Date: 08/30/2019
Date Signed: 09/03/2019 10:22:06 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/18/2019 and conducted by Evaluator Claudia Henley
PUBLIC
COMPLAINT CONTROL NUMBER: 04-CC-20190618103212

FACILITY NAME:TURNER, ALICIA FAMILY CHILD CAREFACILITY NUMBER:
503908423
ADMINISTRATOR:TURNER, ALICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 892-4730
CITY:PATTERSONSTATE: CAZIP CODE:
95363
CAPACITY:14CENSUS: 9DATE:
08/30/2019
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Alicia TurnerTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Licensee failed to report an incident as required.
INVESTIGATION FINDINGS:
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LPA Claudia Henley conducted a complaint investigation today. I was met by licensee and her assistant. On 6/11/19, licensee received a visit from the Patterson Police Department regarding a complaint from a parent with a concern regarding the care that was being provided by the licensee. The Patterson Police Department observed that the child in question was in good health and appeared to be in no danger. Licensee failed to notify the department of this incident within the time frame specified by Title 22 Regulation. Licensee did not notify the department by telephone until 6/18/19, when at that time she was advised to forward a written incident report to the department. Based upon information and interviews which were conducted, the preponderance of evidence standard has been met, therefore the allegations are found to be SUBSTANTIATED.
California Code of Regulations, The following deficiencies are in violation of Title 22, Division 12 CCR, are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
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 04-CC-20190618103212
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

FACILITY NAME: TURNER, ALICIA FAMILY CHILD CARE
FACILITY NUMBER: 503908423
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/30/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/30/2019
Section Cited
HSC
1597.467(b)(1)(2)
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Health & Safety Code - Section 1597.467: Reporting Requirements - The licensee shall report the following information the Department by telephone or fax within the Department's next business day and during normal working hours (8am to 5pm).
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Licensee submitted a written incident report to the department dated 6/19/19 following a telephone conversation with LPA Henley on 6/18/19. POC cleared
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In addition, a written report shall be submitted to the department within seven days following the occurrence of any events. Licensee failed to notify the department by telephone of an incident per this regulation.
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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: Alice JuarezTELEPHONE: (559) 650-7857
LICENSING EVALUATOR NAME: Claudia HenleyTELEPHONE: (559) 341-5776
LICENSING EVALUATOR SIGNATURE:

DATE: 08/30/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/30/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3