153808307-2-17-2022-04-CC-DLEN-CBXRK4-20220224120451

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 153808307
Report Date: 02/17/2022
Date Signed: 02/17/2022 03:57:00 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1310 E. SHAW AVE,
FRESNO, CA 93710

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/10/2021 and conducted by Evaluator Jeovanna Yanez

PUBLIC

COMPLAINT CONTROL NUMBER: 04-CC-20211210124348

FACILITY NAME:	A GOOD TIME OUT		FACILITY NUMBER:	153808307
ADMINISTRATOR:	SHERMAN, MELANIE/KAREN		FACILITY TYPE:	850
ADDRESS:	3400 CALLOWAY DRIVE, SUITE 501		TELEPHONE:	(661) 410-8463
CITY:	BAKERSFIELD	STATE: CA	ZIP CODE:	93312
CAPACITY:	31	CENSUS: 25	DATE:	02/17/2022
		UNANNOUNCED	TIME BEGAN:	03:10 PM
MET WITH:	Karen Kiser		TIME COMPLETED:	03:40 PM

ALLEGATION(S):

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Facility did not meet child's toileting needs.

INVESTIGATION FINDINGS:

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On 02/17/2022, Licensing Program Analyst (LPA) Jeovanna Yanez arrived at the facility to conduct an unannounced complaint inspection. The purpose of the inspection was to gather information regarding the above listed complaint allegation and deliver investigation findings. LPA met with Owner, Karen Kiser, and a census was taken. During the course of this investigation, LPA reviewed records and interviewed staff and parents.

Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the allegation is UNSUBSTANTIATED. Per California Code of Regulations, Title 22, Division 12, Chapter 1, no deficiency was cited during today's inspection.

An exit interview was conducted with Karen Kiser. A copy of this report and Appeal Rights were provided and discussed. A Notice of Site Visit (LIC 9213) form will be posted on the facility's parent's board and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Diana deLeon
LICENSING EVALUATOR NAME: Jeovanna Yanez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2022

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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