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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313623785
Report Date: 01/31/2024
Date Signed: 01/31/2024 04:07:08 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
01/17/2024 and conducted by Evaluator Lea Habtom
COMPLAINT CONTROL NUMBER: 03-CC-20240117151916

FACILITY NAME:LILY PAD EARLY LEARNING CENTERFACILITY NUMBER:
313623785
ADMINISTRATOR:THATCHER, STACIFACILITY TYPE:
850
ADDRESS:3330 CHISOM TRAILTELEPHONE:
(530) 863-9443
CITY:LOOMISSTATE: CAZIP CODE:
95650
CAPACITY:30CENSUS: 7DATE:
01/31/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Marlene Freed/EkstrandTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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Staff signed out daycare child without proper authorization
Daycare child was left unsupervised
Staff engaged in an alteration in front of daycare children
INVESTIGATION FINDINGS:
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Staff signed out daycare child without proper authorization

During the investigation, LPA Habtom toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that staff signed out and released daycare children without proper authorization. Based on the reporting party contact, the employees signed out and released a child to the parent without verifying the parents’ identification by checking ID. Interviews revealed that some parents picked up their children without signing out on the application leaving the staff to complete the sign out process. In the morning, a change of staff occurred, with new staff members unfamiliar to all the children and parents. The parent handbook states that children will be released to parents on enrollment forms or parents can authorize a designated party to pick up with proof of identification. Interviews revealed that employees failed to verify parents on enrollments forms and check photo identification at pick up therefore the allegation staff signed out and released daycare child without proper authorization is to be SUBSTANTIATED: meaning that the allegation is valid because the preponderance of the evidence standard has been met.
Report continued on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 03-CC-20240117151916
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: LILY PAD EARLY LEARNING CENTER
FACILITY NUMBER: 313623785
VISIT DATE: 01/31/2024
NARRATIVE
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Daycare child was left unsupervised.

During the investigation, LPA Habtom toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that a daycare child was left unattended. In the morning, a change of staff occurred, with new staff members. Interviews revealed that when the change happened, a staff member transitioned the children into one room with a teacher, inadvertently leaving one child behind in the room unattended. Based on the corroborating information collected, LPA has found that a daycare child was left unattended to be SUBSTANTIATED: meaning that the allegation is valid because the preponderance of the evidence standard has been met.

Staff engaged in an alteration in front of daycare children

During the investigation, LPA Habtom toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that staff engaged in an altercation in front of daycare children. Interviews indicated that profanity was spoken in the presence of daycare children during a tense moment. Based on the corroborating information collected, LPA has found that a daycare children’s personal rights were violated therefore the allegation that an altercation occurred in front of daycare children to be SUBSTANTIATED: meaning that the allegation is valid because the preponderance of the evidence standard has been met.

Upon receipt of this report, the Licensee shall post the Notice of Site Visit and any Licensing report documenting a type “A” deficiency. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain posting as required, will result in an immediate $100 civil penalty. A copy of this report shall be provided to the parent/guardian of children currently enrolled by the next business day or immediately upon return. A copy of this report shall also be provided to the parent/guardian of any newly enrolled children for the next 12 months (1 year). The Acknowledgement of Receipt (LIC 9224 form must be maintained in each child’s file immediately upon receipt from parent. Licensee was provided with a copy of the Acknowledgement of Receipt of Licensing Reports (LIC 9224) Form during this visit.

This report was reviewed with designated representative, Marlene Freed/Ekstrand. A notice of site visit and appeal rights were provided.

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 03-CC-20240117151916
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: LILY PAD EARLY LEARNING CENTER
FACILITY NUMBER: 313623785
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/01/2024
Section Cited
CCR
101229(a)(1)
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101229(a)(1) Responsibility for Providing Care and Supervision: (a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision...Supervision shall include visual observation.
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Owner, Michelle, states training would be conducted to review policy on supervision & ensure that the tracking sheets are being used. Sign in sheet of the training will be provided to LPA by POC date.
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This requirement was not met as evidenced by: Interviews which indicated that a child was left unattended in a classroom with no supervision which is an immediate health and safety risk to the children in care.
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Type A
02/01/2024
Section Cited
CCR
101223(a)(2)
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101223(a)(2)Personal Rights: (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

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Owner, Michelle, states she would continue training & workshops on how to speak with children. Positive Descriptive Acknowledgment will also be reinforced. Sign in sheet of the training will be provided to LPA by POC date.
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This requirement was not met as evidenced by: Interviews that profanity was used in front of daycare children which is an immediate health and safety risk to the children 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: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 03-CC-20240117151916
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: LILY PAD EARLY LEARNING CENTER
FACILITY NUMBER: 313623785
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/31/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/29/2024
Section Cited
CCR
101219(f)
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101219(f) Admission Agreement: (f) The licensee shall comply with all terms and conditions set forth in the admission agreement. This requirement was not met as evidenced by: Interviewes that revealed authorized representatives identity
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Owner, Michelle, states she will send a newsletter with the proper steps to parents to use the application to sign in and sign out. A personal message will also be sent in procare for parents to review regarding sig in & sign out procedures.
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were not verified when parents failed to sign
out using the application which posses a potential health and safety risk to the children in care.
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 New staff are placed with seasoned staff to familiarize them with the authorized representatives.
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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: Lea Habtom
LICENSING EVALUATOR SIGNATURE:

DATE: 01/31/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/31/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5