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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313623043
Report Date: 12/15/2023
Date Signed: 12/15/2023 09:51:46 AM

Unsubstantiated


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
10/26/2023 and conducted by Evaluator Jeremey McClain
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20231026162624
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: 19DATE:
12/15/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:David TuckerTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Staff member caused an injury to child's eye and buttocks while they were in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jeremey McClain met with licensee David Tucker to deliver findings for a complaint investigation. LPA observed 19 children supervised by five staff.

It was alleged that a staff member caused an injury to a child's eye and buttocks while they were in care.

During the investigation, LPA conducted interviews with licensee and staff. LPA reviewed recorded footage of the alleged dates of the incidents. LPA revewed attendance sheets, and updates documented in an application by staff regarding daily activity for Child 1. A detective from Roseville Police department also conducted and investigation. AN MDIC interview with Child 1 was conducted. The evidence gathered did not suggest that the allegations were valid. There were no documented bruises or injuries of Child 1 by staff. Staff interviews were consistent that Child 1 had a normal demeanor while in care and did not show any distress.
Continued on the following page...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
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 2
Control Number 03-CC-20231026162624
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: BUILDING KIDZ SCHOOL - EUREKA (PS)
FACILITY NUMBER: 313623043
VISIT DATE: 12/15/2023
NARRATIVE
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 While reviewing footage, LPA observed that Staff 1 did not engage inappropriately with Child 1 when they interacted. LPA also observed interaction between Staff 1 and Child 1 to be minimal. The MDIC with Child 1 did not produce any significant evidence to corroborate the claims.

The preponderance of evidence standard has not been met; therefore, the allegation is determined to be UNSUBSTANTIATED. The allegation can neither be corroborated nor dismissed.

No Title 22 deficiencies will be issued as a result of the investigation. LPA reviewed this report with licensee David Tucker, and provided a Notice of Site Visit that must be posted for 30 days. LPA provided appeal rights.
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:

DATE: 12/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2