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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 293624573
Report Date: 10/05/2023
Date Signed: 10/05/2023 03:38:05 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 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
08/08/2023 and conducted by Evaluator Matthew Gallo
COMPLAINT CONTROL NUMBER: 03-CC-20230808103414
FACILITY NAME:LITTLE BUGS LEARNING CENTERFACILITY NUMBER:
293624573
ADMINISTRATOR:MADISON, HEATHERFACILITY TYPE:
850
ADDRESS:714 WEST MAIN STREETTELEPHONE:
(530) 477-9800
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95945
CAPACITY:24CENSUS: 8DATE:
10/05/2023
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Heather MadisonTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Ratio: Facility is operating out of ratio
INVESTIGATION FINDINGS:
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On 10/5/2023, Licensing Program Analyst (LPA) Gallo met with facility representative Heather Madison to deliver findings of the complaint investigation opened on 8/8/2023. Upon arrival, LPA observed a census of 8 preschool children supervised by 3 staff.

It was alleged that the facility was operating out of ratio. Throughout the investigation, LPA conducted observations, reviewed video surveillance footage, and interviewed staff, children, and parents. Video footage taken of 8/7/2023 revealed a six minute period in the morning when a single teacher was providing supervision to thirteen children. Title 22 regulation requires a ratio of 1 teacher to every 12 students. The preponderance of evidence standard has been met, and therefore the allegation that the facility was operating out of ratio is SUBSTANTIATED. A Type A deficiency is cited on the following 9099-D.

Continued on 9099-C
Substantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
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 03-CC-20230808103414
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LITTLE BUGS LEARNING CENTER
FACILITY NUMBER: 293624573
VISIT DATE: 10/05/2023
NARRATIVE
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Licensee acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 809D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided.

Exit interview conducted and report was reviewed with the facility representative Heather Madison. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 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
08/08/2023 and conducted by Evaluator Matthew Gallo
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230808103414

FACILITY NAME:LITTLE BUGS LEARNING CENTERFACILITY NUMBER:
293624573
ADMINISTRATOR:MADISON, HEATHERFACILITY TYPE:
850
ADDRESS:714 WEST MAIN STREETTELEPHONE:
(530) 477-9800
CITY:GRASS VALLEYSTATE: CAZIP CODE:
95945
CAPACITY:24CENSUS: 8DATE:
10/05/2023
UNANNOUNCEDTIME BEGAN:
02:10 PM
MET WITH:Heather MadisonTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Personal Rights: Staff caused injury to child in care
Personal Rights: Staff yells at children in care
INVESTIGATION FINDINGS:
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On 10/5/2023, Licensing Program Analyst (LPA) Gallo met with facility representative Heather Madison to deliver findings of the complaint investigation opened on 8/8/2023. Upon arrival, LPA observed a census of 8 preschool children supervised by 3 staff.

It was alleged that (1) facility staff caused injury to a child in care and (2) facility staff yells at children in care. Throughout the investigation, LPA conducted observations, record review, video surveillance review, and interviewed Reporting Party, staff, parents, and children.

Regarding the allegation the facility staff caused injury to a child in care, medical records obtained by the department's Investigation's Branch regarding the injury do not provide conclusive evidence that the injury was caused by a staff member or was related to the child’s time at the facility. Review of available surveillance footage from the day of the alleged injury (8/7/2023) and interviews with staff, parents, and children did not reveal any further evidece that supported the conclusion that the injury was caused by staff. Based on the investigation, there is not a preponderance of evidence to prove the allegation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

Report continues on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 03-CC-20230808103414
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: LITTLE BUGS LEARNING CENTER
FACILITY NUMBER: 293624573
VISIT DATE: 10/05/2023
NARRATIVE
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Regarding the allegation that facilty staff yells at children in care, LPA's review of available video surveillance footage and interviews with staff, parents, and children did not reveal any concrete evidence that staff yells at children. Therefore, this allegation is also UNSUBSTANTIATED.

Exit interview conducted and report was reviewed with the licensee facility representative Heather Madison. A notice of site visit was given and must remain posted for 30 days.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 03-CC-20230808103414
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: LITTLE BUGS LEARNING CENTER
FACILITY NUMBER: 293624573
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/05/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/06/2023
Section Cited
CCR
101216.3(a)
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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...

This requirement was not met as evidenced by:
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Facility representative Madison has already revised ratio policy to reaffirm the necessity of ratio and had all staff members read and sign. LPA reviewed copies. Return visit will be conducted to ensure compliance.
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Based on review of video footage from the day 8/7/2023, LPA determined that a teacher was left alone with 13 children for several minutes. This poses and immediate health, safety, or personal rights to persons in care.
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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: Keven Peters
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/05/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/05/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5