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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 570305378
Report Date: 05/20/2022
Date Signed: 05/20/2022 01:39:34 PM

Substantiated


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
05/18/2022 and conducted by Evaluator Chayntel Hunter
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20220518135505
FACILITY NAME:YMCA OF SUPERIOR CALIFORNIA-YOLO PRESCHOOLFACILITY NUMBER:
570305378
ADMINISTRATOR:KATIE GUINANFACILITY TYPE:
850
ADDRESS:1300 COLLEGE STREETTELEPHONE:
(530) 662-1086
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:69CENSUS: 37DATE:
05/20/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Katie GuinanTIME COMPLETED:
01:45 PM
ALLEGATION(S):
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Daycare child wandered away from the facility
Facility operating out of ratio
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Chayntel Hunter and Investigator (IB) Melissa Bennett met with Director, Katie Guinan to open and close the complaint investigation regarding the above allegations.
During the course of the investigation, LPA Hunter and IB Bennett conducted interviews, and obtained information pertaining to the allegations.

It was alleged that a daycare child wandered away from the facility. During interviews conducted it was revealed that a child (C1) walked approximately 55ft away from teachers and was unattended for a period of time. It was also alleged that the facility was operating out of ratio. Interviews conducted revealed that, after the incindet occured, there was a period of time where there were approximately 30 children outside with a teacher and an aide.

Report continues on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
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 3
Control Number 53-CC-20220518135505
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: YMCA OF SUPERIOR CALIFORNIA-YOLO PRESCHOOL
FACILITY NUMBER: 570305378
VISIT DATE: 05/20/2022
NARRATIVE
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Based on the interviews conducted and a review of records, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Title 22 regulations are being cited on the attached 9099-D page. An exit interview was conducted with the Director. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Hunter informed Facility Representative, Katie Guinan that this report dated 05/20/2022 documents 2 Type A citations, which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Hunter informed the Facility Representative to provide a copy of this licensing report dated 05/20/2022 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20220518135505
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: YMCA OF SUPERIOR CALIFORNIA-YOLO PRESCHOOL
FACILITY NUMBER: 570305378
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/20/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/23/2022
Section Cited
CCR
101229(a)(1)
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Responsibility for Providing Care and Supervision 101229 (a) The licensee shall provide care and supervision... (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation. This requirement was not met as evidenced by:
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Director stated that staff will conduct 15min head counts, and is trying to install a gate to section off the yard so staff are able to supervise children effectively. Director will also hold a staff meeting to discuss Title 22 regulations regarding supervision of children, and communication amongst staff.
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Based on interviews conducted and a review of records it was determined that C1 wandered approximately 55ft away from staff and was left unattended for a period of time. This is an immediate health and safety risk to children in care.
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Type A
05/23/2022
Section Cited
CCR
101216.3(b)(1)
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Teacher-Child Ratio 101216.3 (b) The licensee may use teacher aides in a teacher-child ratio... (1) A ratio of one fully qualified teacher and one aide for every 18 children in attendance in a preschool program is allowed... This requirement was not met as evidenced by:
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Director stated that staff will conduct 15min head counts to ensure the correct number of staff are present to supervise children. Director will also hold a staff meeting to discuss Title 22 regulations regarding supervision of children, staff qualifications and ratios.
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Based on interviews conducted it was revealed that one teacher and one aide were outside with approximately 30 children for a period of time. This is an immediate health and safety risk to children in care.
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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.
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2022
LIC9099 (FAS) - (06/04)
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