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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 573622056
Report Date: 01/03/2024
Date Signed: 01/03/2024 01:00:17 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/26/2023 and conducted by Evaluator Lauren Scott
COMPLAINT CONTROL NUMBER: 53-CC-20230926151604
FACILITY NAME:ESCAMILLA, DONITAFACILITY NUMBER:
573622056
ADMINISTRATOR:ESCAMILLA, DONITAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 921-6498
CITY:WOODLANDSTATE: CAZIP CODE:
95695
CAPACITY:14CENSUS: 7DATE:
01/03/2024
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:licensee, Donita EscamillaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee did not provide adequate supervision to a daycare child while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Lauren Scott conducted an unannounced complaint investigation inspection and met with Licensee, Donita Escamilla. The purpose of the inspection was to inform the Licensee of the finding for the above complaint allegation. It was alleged that Licensee did not provide adequate supervision to a daycare child while in care. An Investigator from the Department’s Investigations Branch conducted the investigation in collaboration with LPA Lauren Scott. The investigator conducted interviews with staff, parents and children. Licensee stated children are well supervised and C1 was within line of sight. Although an injury occurred, IB could not determine if it was due to a lack of supervision.
Based on the information obtained throughout the course of this investigation the above allegation 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. 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Chayntel HunterTELEPHONE: (916) 917-8620
LICENSING EVALUATOR NAME: Lauren ScottTELEPHONE: (916) 926-9488
LICENSING EVALUATOR SIGNATURE:

DATE: 01/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/03/2024
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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