<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 313623982
Report Date: 09/10/2021
Date Signed: 09/10/2021 12:25:02 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
09/09/2021 and conducted by Evaluator Katrina Owens
COMPLAINT CONTROL NUMBER: 03-CC-20210909111434
FACILITY NAME:ESCUE, HANNAH & AVILLA, ANDREWFACILITY NUMBER:
313623982
ADMINISTRATOR:HANNAH ESCUEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 430-3325
CITY:ROSEVILLESTATE: CAZIP CODE:
95747
CAPACITY:14CENSUS: 10DATE:
09/10/2021
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Hannah Escue - LicenseeTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
LICENSE: Facility is out of ratio.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
An unannounced inspection was conducted today by Licensing Program Analyst Owens. LPA met with licensee, Hannah Escue. Present at tine of inspection were licensee, her husband, Andrew and 10 day care children. The purpose of the inspection is to open and close a complaint investigation. Interviews and a tour of the facility was conducted.

Based on interviews and review of documents the licensee was out of ratio by having two infants over the allotted amount in care at one time. Licensee did not confirm infant's date of birth on paperwork, she took the word of the parents. When she was completing paperwork for a program she realized she had more infants in care than allowed by Title -22 regulations.

The preponderance of evidence standard has been met during this investigation, therefore the above allegation is found to be SUBSTANTIATED. Violations of the California Code of Regulations, Title 22, Division 12 & Chapter 3 are being cited on the attached LIC9099D.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
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-20210909111434
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: ESCUE, HANNAH & AVILLA, ANDREW
FACILITY NUMBER: 313623982
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/10/2021
Section Cited
CCR
102416.5(d)(1)
1
2
3
4
5
6
7
STAFFING RATIO & CAPACITY:
Twelve children, no more than four of whom may be infants;.
This requirement is not met as evidence by licensee was out of ratio by two infants.
1
2
3
4
5
6
7
Licensee will confirm child's date of birth with paperwork at all times.
Licensee currently has 4 infants enroll at her facility and is in compliance with Title-22 regulations.
Deficiency cleared at time of
8
9
10
11
12
13
14
Licensee took parent word for child's age and did not confirm with paperwork/ documents.
This is an immediate risk to children.
8
9
10
11
12
13
14
inspectiion.

LPA gave licensee LIC9224 to be given to parents for signature
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Katrina Owens
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2