543909967-1-22-2021-04-CC-SFAG-BXN3CL-20210126170803

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 543909967
Report Date: 01/21/2021
Date Signed: 01/22/2021 11:08:39 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
10/29/2020 and conducted by Evaluator Theresa Marquez

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20201029144608

FACILITY NAME:	PERGESON, CHELSIE FAMILY CHILD CARE		FACILITY NUMBER:	543909967
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 4	DATE:	01/21/2021
		UNANNOUNCED	TIME BEGAN:	04:30 PM
MET WITH:	Chelsie Pergeson		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

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Provider left day care child in soiled clothing.

Provider spoke inappropriately in front of day care child.

INVESTIGATION FINDINGS:

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On 1/21/2021, LPA Theresa Marquez contacted Licensee Chelsie Pergeson via telephone due to COVID-19 restrictions. The purpose of the contact is to provide complaint findings in regards to the above allegations.
During the course of this investigation, LPA interviewed staff and other individuals associated to this facility/investigation. After a day care child urinated, she sat in partially wet clothing while Licensee cleaned the urine from day care room floor. And, although Licensee and parent engaged in a verbal disagreement, inconsistent statements made by the same individuals fail to support that Licensee spoke in an inappropriate manner.

Due to the above information obtained, the allegations are unsubstantiated. Meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur.

Per California Code of Regulations, Title 22, Division 12, no deficiency was cited today.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Susie Fanning	TELEPHONE: (559) 650-7890
LICENSING EVALUATOR NAME: Theresa Marquez	TELEPHONE: (559) 341-7123
LICENSING EVALUATOR SIGNATURE:	DATE: 01/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/21/2021

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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