550321246-8-2-2022-53-CC-JSMH-CGZTNT-20220805145316

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 550321246
Report Date: 08/02/2022
Date Signed: 08/02/2022 08:09:07 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/27/2022 and conducted by Evaluator Elvira Sierra

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20220427124541

FACILITY NAME:	KOUNTRY KIDS PRESCHOOL		FACILITY NUMBER:	550321246
ADMINISTRATOR:	ECROYD, DENISE		FACILITY TYPE:	850
ADDRESS:	229 SOUTH SHEPHERD STREET		TELEPHONE:	(209) 533-1500
CITY:	SONORA	STATE: CA	ZIP CODE:	95370
CAPACITY:	60	CENSUS: 35	DATE:	08/02/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Denise Ecroyd		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Personal Rights-Day-care child sustained an injury while in care
Reporting Requirements-Authorized representative is not notified of incidents

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On Tuesday, August 2nd, 2022, at 01:30pm, Licensing Program Analyst (LPA) Elvira Sierra conducted an unannounced complaint inspection to deliver findings of the above allegations. LPA met with Director, Denise Ecroyd, who guided LPA on a tour of the facility. Upon arrival, present in the facility were 35 preschool age children being supervised by seven staff members who have all been fingerprint cleared through Community Care Licensing.

Reporting Party (RP) alleged that child #1 (C1) sustained an injury while in care and authorized representative was not notified of incidents. Through interviews and records review, it was revealed incident that occurred on 04/26/22 was observed by a staff member who administer immediate care to C1 and incident was reported to the parents in a timely manner. Also records indicated that incidents were disclosed to authorized representatives and a signature as a confirmation was obtained. Director stated that facility uses an Injury/Accident Report form to document any incidents and to inform parents. Staff reported that if the injury involves any part of the child’s head, parents are call or text immediately. All other injuries staff asses the child, administer first aid and parents are informed at the time of pick up. Director stated facility follows all Licencing Regulations and even goes above and beyond notifying parents of any injuries/illness.
Report continues on susuquent page 809C--

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 2

Control Number 53-CC-20220427124541

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: KOUNTRY KIDS PRESCHOOL	FACILITY NUMBER: 550321246
	VISIT DATE: 08/02/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

Based on the information obtained through documentation and interviews; 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, therefore the allegations are unsubstantiated.

This report and Appeals of Rights were provided and reviewed with the Director, Denise Ecroyd. Notice of Site Visit posted and should remain posted for 30 days.

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Elvira Sierra	TELEPHONE: (916) 216-8826
LICENSING EVALUATOR SIGNATURE:	DATE: 08/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/02/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2