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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 515402881
Report Date: 08/27/2021
Date Signed: 10/14/2021 10:22:21 AM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/01/2021 and conducted by Evaluator Mikah Martinez
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20210701102636
FACILITY NAME:INGRAM FAMILY CHILD CARE HOMEFACILITY NUMBER:
515402881
ADMINISTRATOR:INGRAM, CHRISTY & SHAWNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 671-5162
CITY:YUBA CITYSTATE: CAZIP CODE:
95993
CAPACITY:12CENSUS: DATE:
08/27/2021
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Christy IngramTIME COMPLETED:
09:45 AM
ALLEGATION(S):
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Provider hit day care child.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Martinez conducted an unannounced complaint visit and met with licensees Christy and Shawn Ingram. It was alleged the licensee hit a day care child, specifically that she slapped a child (C1) with a pull up. The licensee was interviewed on 7/9/21 and denied the allegation. She stated that she has never hit a child. She stated that she does not assist children who are potty training when they have urinated, and that she just hands them a pull-up. LPA Martinez interviewed two witnesses (W1 and W2) on 8/10/21 at 2:50PM who stated that the licensee had gotten annoyed with C1 and hit him with a pull up on the stomach. W1 demonstrated to LPA Martinez that the Licensee swatted at C1 in the stomach and W2 agreed. The swat was not forceful and did not cause any injuries. Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted.

The Notice of Site Visit must be posted for 30 days.
Substantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
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 13-CC-20210701102636
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: INGRAM FAMILY CHILD CARE HOME
FACILITY NUMBER: 515402881
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type A
10/18/2021
Section Cited
CCR
102423(a)(4)
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Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation,
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This poses an immediate health and safety risk to children in care. Licensee will watch the following video from DSS https://ccld.childcarevideos.org/family-child-care-providers/childrens-personal-rights-in-child-care/ . Once completed the provider will send in writing whether they understand the video.
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ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning. This requirement was not met as evidenced by:
Based on interviews, the licensee did not comply with the section cited above in 1 out of 3 children (C1)
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LIC9224 shall be provided to parents of current children in care and future families for 12 months from todays citation.
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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: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Mikah MartinezTELEPHONE: (530) 895-4014
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
LIC9099 (FAS) - (06/04)
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