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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313623043
Report Date: 07/26/2021
Date Signed: 07/26/2021 01:56:55 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
07/22/2021 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210722154417
FACILITY NAME:BUILDING KIDZ SCHOOL - EUREKA (PS)FACILITY NUMBER:
313623043
ADMINISTRATOR:JO ANN FERNANDEZFACILITY TYPE:
850
ADDRESS:1485 EUREKA RD, STE G170TELEPHONE:
(916) 780-5437
CITY:ROSEVILLESTATE: CAZIP CODE:
95661
CAPACITY:58CENSUS: 15DATE:
07/26/2021
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:David TuckerTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Staff yelled at a child in care and handled them in rough manner.
INVESTIGATION FINDINGS:
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On July 26th, 2021 at 1:00 pm, Licensing Program Analyst (LPA) Jeremey McClain met with Licensee David Tucker for the purpose of a complaint investigation. At the time of arrival, LPA observed 15 children supervised by two staff members. It was alleged that staff member did not honor the personal rights of a child in care by rough handling them and yelling at them. On June 18th, 2021, Licensee reported an unusual incident, stating that on 06/17/2021, Staff #1 inappropriately handled and spoke to Child #1 as a form of discipline. During the investigation, LPA conducted interviews, and reviewed documents relevant to the investigation. Based on the evidence that was gathered was sufficient to corroborate the allegation. The preponderance of evidence standard has been met, therefore, the allegation is determined to be substantiated.
Title 22 deficiencies are cited on the subsequent page of this report. If not corrected, these violations pose an immediate risk to the health and safety of children in care. Licensee acknowledges, that upon receipt TYPE A DEFICIENCIES, a LIC 9099-D with Type A deficiencies shall be posted for 30 days. Licensee also acknowledges that they must provide copies of this licensing report to parents/guardians of children in care and to parents/guardians of children newly enrolled at the facility during the next 12 months. LPA provided an LIC 9224, which must be signed by parents/guardians and kept with the children's files. Appeal Rights were provided. An exit interview was conducted, and a Notice of Site Visit posted.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021
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 2
Control Number 03-CC-20210722154417
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: BUILDING KIDZ SCHOOL - EUREKA (PS)
FACILITY NUMBER: 313623043
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/26/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/26/2021
Section Cited
CCR
101223(a)(1)
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Personal Rights.(a)The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement was not met as evidenced by the unusual incident reported on 06/17/2021 by licensee, which
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Licensee informed Staff #1 that her actions were not acceptable and placed Staff #1 on a performance improvement plan for 90 days. Licensee informed Staff #1 that if a second incident occurred, then they would be terminated.
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stated that Staff #1 reacted to Child #1 misbehavior towards other children by yelling at Child #1 and forcefully moving them in a manner that was inappropriate. If not corrected, this poses an immediate risk to the health and safety of children in care.
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 Licensee required Staff #1 and other staff to complete trainings on personal rights, classroom management, and positive discipline. Licensee stated that Child #1 parents were notified of the incident as well.
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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: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2