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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340305706
Report Date: 08/31/2023
Date Signed: 09/04/2023 11:25:45 PM

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
06/30/2023 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230630132451
FACILITY NAME:FOREVER YOUNG INFANT CARE CENTERFACILITY NUMBER:
340305706
ADMINISTRATOR:TYSON, SELINAFACILITY TYPE:
830
ADDRESS:1209 P STREET #12TELEPHONE:
(916) 446-4246
CITY:SACRAMENTOSTATE: CAZIP CODE:
95814
CAPACITY:20CENSUS: DATE:
08/31/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Selina TysonTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff did not ensure that day care child's diapering needs were met while in care.
Staff did not ensure that day care child's sleeping needs were met while in care.
Staff did not ensure that day care child was fed as necessary.
Lack of staff supervision resulting in day care child sustaining unexplained injuries while in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Gagandeep Singh and Dao Vang met with the facility representative, Selina Tyson, to deliver the complaint findings. Purpose of the inspection was explained.

During the investigation, LPAs inspected the facility, reviewed facility records, interviewed staff and parents. Children were not interviewed because they are non-verbal. During the investigation, facility staff stated the diapers are being changed every two hours, also more often as needed. Facility provided the diaper change log as supporting evidence. It was found that facility has children from toddler classroom sleep once a day and let the children sleep more if the child needs to sleep. It was found that the facility has feeding schedule in place and LPAs observed feeding log. During staff interivews, it was found that the staff was aware of each child's feeding needs. During record review, it was found that the facility has documentation of each incident that the child was involved in and during interviews, it was stated that the incidents were reported verbally to the parent and a written incident report is being provided at the end of the day.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
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-20230630132451
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: FOREVER YOUNG INFANT CARE CENTER
FACILITY NUMBER: 340305706
VISIT DATE: 08/31/2023
NARRATIVE
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Continuation from previous page ...........

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. Copy of this report was reviewed and provided to the facility representative, Selina Tyson. Notice of site visit is posted and shall remain posted for next 30 days.
SUPERVISOR'S NAME: Natalie DunawayTELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (916) 216-7823
LICENSING EVALUATOR SIGNATURE:

DATE: 08/31/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2