313623960-7-28-2023-03-CC-KPES-CVDLP2-20230905085512

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 313623960
Report Date: 07/28/2023
Date Signed: 07/28/2023 10:38:53 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
07/13/2023 and conducted by Evaluator Katrina Owens

COMPLAINT CONTROL NUMBER: 03-CC-20230713115438

FACILITY NAME:	KIDZCOMMUNITY EARLY LEARNING CENTER, ADELANTE		FACILITY NUMBER:	313623960
ADMINISTRATOR:	HOLLY CLEMENT		FACILITY TYPE:	830
ADDRESS:	350 ATLANTIC STREET		TELEPHONE:	(530) 886-4131
CITY:	ROSEVILLE	STATE: CA	ZIP CODE:	95678
CAPACITY:	16	CENSUS: 5	DATE:	07/28/2023
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Ginger Park - Site Supervisor		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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PERSONAL RIGHTS: Staff caused injury to a daycare child.

INVESTIGATION FINDINGS:

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An unannounced inspection was conducted today by Licensing Program Analyst Owens. Licensing Program Analyst Owens met with Ginger Park, Site Supervisor. Present at time of inspection were 5 infants and 4 staff.

The purpose of the inspection is to close a complaint investigation that was originally opened on July 18, 2023. Based on conflicting interviews, the allegation that staff caused an injury to a day-care child is unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the allegation did or did not occur.

No citation issued. An exit interview was conducted. Appeal rights were given and explained to the site supervisor at time of inspection.

A notice of site visit was given and must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:	DATE: 07/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023

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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