<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 573620071
Report Date: 08/18/2021
Date Signed: 08/18/2021 01:50:13 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
07/26/2021 and conducted by Evaluator Chayntel Hunter
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20210726150508
FACILITY NAME:TWINKLE LITTLE STAR CENTERFACILITY NUMBER:
573620071
ADMINISTRATOR:INIGUEZ, JOSEFINAFACILITY TYPE:
830
ADDRESS:1401 EAST GUM AVETELEPHONE:
(530) 204-9709
CITY:WOODLANDSTATE: CAZIP CODE:
95776
CAPACITY:12CENSUS: 1DATE:
08/18/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Director, Josefina IniguezTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Infant sustained injury while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On August 18, 2021 Licensing Program Analyst (LPA) Chayntel Hunter met with Director, Josefina Iniguez to deliver the findings of the complaint investigation regarding the above allegation. During the course of the investigation, LPA Hunter conducted interviews, and obtained information pertaining to allegation. It was alleged that child, C1 sustained an injury while in care. Based on interviews conducted it was determined that part of C1's booster sear broke causing C1 to slip out of their booster seat and sustain an injury. Based on the interviews and documents obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

The following Title 22 Deficiency is being cited on the subsequent 9099-D page. Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 9099-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 9099-D in each child's file. Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
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 4
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
07/26/2021 and conducted by Evaluator Chayntel Hunter
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20210726150508

FACILITY NAME:TWINKLE LITTLE STAR CENTERFACILITY NUMBER:
573620071
ADMINISTRATOR:INIGUEZ, JOSEFINAFACILITY TYPE:
830
ADDRESS:1401 EAST GUM AVETELEPHONE:
(530) 204-9709
CITY:WOODLANDSTATE: CAZIP CODE:
95776
CAPACITY:12CENSUS: 1DATE:
08/18/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Director, Josefina IniguezTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of supervision resulting in infant being bitten by another Infant.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On August 18, 2021 Licensing Program Analyst (LPA) Chayntel Hunter met with Director, Josefina Iniguez to deliver the findings of the complaint investigation regarding the above allegation. During the course of the investigation, LPA Hunter conducted interviews, and obtained information pertaining to allegation. It was alleged that a child, C1 was bitten by another infant due to lack of supervision. Based on the interviews conducted, although C1 was bitten by another infant, it was determined that staff were present during the incident and witnessed the incident.

Based on the information obtained throughout the course of this investigation the above allegations could not be substantiated or dismissed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the finding is UNSUBSTANTIATED. Exit interview was conducted. Appeal rights were printed and provided. Notice of Site Visit was provided and should remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 53-CC-20210726150508
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: TWINKLE LITTLE STAR CENTER
FACILITY NUMBER: 573620071
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/18/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/19/2021
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
CCR 101223(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Director stated she will purchase new straps for the booster seats to ensure they are safe for children. If new straps cannot be purchased the Director will replace the seats. Director will inform LPA when items are purchased so they can be inspected.
8
9
10
11
12
13
14
Based on interviews conducted it was determined that part of C1's booster seat broke and C1 slipped through the booster seat and sustained an injury. This is an immediate 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.
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Chayntel Hunter
LICENSING EVALUATOR SIGNATURE:

DATE: 08/18/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/18/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4