570308535-8-24-2021-53-CC-BENN-C6ALBK-20210827083648

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 570308535
Report Date: 08/24/2021
Date Signed: 08/24/2021 12:04:30 PM

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
07/22/2021 and conducted by Evaluator Amy Silva

COMPLAINT CONTROL NUMBER: 53-CC-20210722124244

FACILITY NAME:	RUSSELL PARK CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	570308535
ADMINISTRATOR:	SHELBY FARIA		FACILITY TYPE:	850
ADDRESS:	400 RUSSELL PARK		TELEPHONE:	(530) 753-2487
CITY:	DAVIS	STATE: CA	ZIP CODE:	95616
CAPACITY:	80	CENSUS: 41	DATE:	08/24/2021
		UNANNOUNCED	TIME BEGAN:	11:35 AM
MET WITH:	Sarah Tibbett		TIME COMPLETED:	12:20 PM

ALLEGATION(S):

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Personal Rights- Daycare child sustained an injury while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Amy Silva conducted a follow up complaint inspection and met with Director Sarah Tibbett, to deliver the findings for the above complaint allegation. During inspection LPA observed 41 children present with eight staff. It was alleged that a daycare child sustained an injury while in care due to facility equipment not being age appropriate. It was also stated by the reporting party that the facility did properly inform them regarding the injury. LPA observed the equipment on 7/30/21 and found the equipment to be age appropriate. LPA conducted interviews with staff and parents. Interviews stated that parents are notified at pick up time and are provided with an incident report.
Based on interviews and information obtained, this allegation is found to be unsubstantiated. An unsubstantiated finding means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur, therefore this allegation is unsubstantiated.
An exit interview was conducted. Appeal rights were given and discussed. A Notice of Site Visit was posted during this inspection.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Bettina Engelman	TELEPHONE: (916) 263-5820
LICENSING EVALUATOR NAME: Amy Silva	TELEPHONE: (916) 926-9100
LICENSING EVALUATOR SIGNATURE:	DATE: 08/24/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/24/2021

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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