573619781-1-28-2021-53-CC-JSMH-BXUT37-20210202132149

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 573619781
Report Date: 01/28/2021
Date Signed: 01/28/2021 02:36:18 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
12/15/2020 and conducted by Evaluator Chayntel Hunter

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20201215132814

FACILITY NAME:	ST. LUKE'S PRESCHOOL & NURSERY SCHOOL (INF)		FACILITY NUMBER:	573619781
ADMINISTRATOR:	LAURIE MOORE		FACILITY TYPE:	830
ADDRESS:	515 SECOND STREET		TELEPHONE:	(530) 662-1853
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95695
CAPACITY:	16	CENSUS:	DATE:	01/28/2021
		UNANNOUNCED	TIME BEGAN:	11:25 AM
MET WITH:	Director, Laurie Moore		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Facility staff are commingling children.

INVESTIGATION FINDINGS:

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The facility was contacted via a telephone call due to the recent COVID19 State of Emergency. Licensing Program Analyst (LPA) Chayntel Hunter spoke with Director, Laurie Moore to deliver the findings of the complaint investigation regarding the above allegation. In lieu of Director's signature, LPA Hunter is emailing the report with a read receipt request.

It was alleged that facility staff were commingling children. During the course of the investigation, LPA Hunter conducted interviews, and obtained information pertaining to the allegation. Through interviews conducted it was confirmed that a child (C1), from the infant/toddler classroom, was placed into the preschool classroom. Although C1 was participating in transition visits, the age between the time of the transition visit and the child turning 2 was too far apart. Director stated facility will be more cautious when transitioning children in the future to ensure age eligibility.

Report continues on 9099-C.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

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 5

Control Number 53-CC-20201215132814

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: ST. LUKE'S PRESCHOOL & NURSERY SCHOOL (INF)	FACILITY NUMBER: 573619781
	VISIT DATE: 01/28/2021

NARRATIVE

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Based on the interviews conducted revealing that a child had been commingled with another age group, 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 9099D page.

Exit interview was conducted. Appeal rights were printed and provided. Notice of Site Visit was provided and should remain posted for 30 days.

SUPERVISOR'S NAME: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

LIC9099 (FAS) - (06/04)

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Control Number 53-CC-20201215132814

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: ST. LUKE'S PRESCHOOL & NURSERY SCHOOL (INF)	FACILITY NUMBER: 573619781
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/28/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 02/26/2021 Section Cited CCR 101161(a)	1 2 3 4 5 6 7	Limitations on Capacity and Ambulatory Status 101161(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	Director stated that the facility will be more cautious when scheduling transition visits with children. Director also stated facility will implement a written agreement for parents to sign notifying them of the scheduled transition visits.
	8 9 10 11 12 13 14	Based on interviews conducted it was revealed that a child (C1), from the infant/toddler classroom was commingled with children in the preschool classroom. This is a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Sharon Ogbodo	TELEPHONE: (916) 263-5721
LICENSING EVALUATOR NAME: Chayntel Hunter	TELEPHONE: (916) 917-8620
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2021

LIC9099 (FAS) - (06/04)

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