313623044-5-9-2023-03-CC-KPES-CRUKMV-20230515080207

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313623044
Report Date: 05/09/2023
Date Signed: 05/09/2023 01:09:08 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, 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
05/01/2023 and conducted by Evaluator Jeremey McClain

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20230501154742

FACILITY NAME:	BUILDING KIDZ SCHOOL - EUREKA (INF)		FACILITY NUMBER:	313623044
ADMINISTRATOR:	JO ANN FERNANDEZ		FACILITY TYPE:	830
ADDRESS:	1485 EUREKA RD, STE G170		TELEPHONE:	(916) 780-5437
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95661
CAPACITY:	7	CENSUS: 5	DATE:	05/09/2023
		UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	David Tucker		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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Child sustained injury while in care

INVESTIGATION FINDINGS:

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On May 9th, 2023, Licensing Program Analyst (LPA) Jeremey McClain met with licensee David Tucker to close a complaint investigation. Upon arrival, LPA observed five infants supervised by two staff. It was alleged that a child sustained blisters on their hand while in care. During the investigation, LPA conducted interviews with staff, observed the infant activity area, and reviewed recorded footage of the infant area.

Video footage of 04/27/2023 shows Child #1 appear to touch a window two times while in care. Audio of the recorded footage was not available. The child did not appear to be in distress after touching the window twice and continued moving through the classroom and interacting with other children and staff. Staff was seen tending to the child minutes after the child touched the window, providing food, whiping the child's face, and changing the child's diaper. At no time during the video did staff tend to the child's hands. The child returned to care the following day on 04/28/2023, and licensee was notified of the blisters after the child was picked after attending care all day. Staff stated that the child had a normal disposition while in care and no blisters were visible. (1/2)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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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Control Number 03-CC-20230501154742

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 (INF)	FACILITY NUMBER: 313623044
	VISIT DATE: 05/09/2023

NARRATIVE

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Based on the evidence that was gathered, LPA determined the preponderance of evidence standard has not been met. Evidence is not conclusive that the child suffered blisters from their activity while in care. Therefore, the allegation can neither be confirmed nor dismissed, and is determined to be unsubstantiated.

There were no Title 22 deficiencies during today’s investigation. LPA reviewed this report with Licensee and provided a Notice of Site Visit that must be posted for 30 days. Appeal Rights were provided.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Jeremey McClain
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC9099 (FAS) - (06/04)

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