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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340306418
Report Date: 03/01/2023
Date Signed: 03/01/2023 12:23:36 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
01/26/2023 and conducted by Evaluator Tanya Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20230126133742
FACILITY NAME:SHILOH ARMS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
340306418
ADMINISTRATOR:ROWENA CAMILLERFACILITY TYPE:
850
ADDRESS:3949 23RD AVENUETELEPHONE:
(916) 453-1309
CITY:SACRAMENTOSTATE: CAZIP CODE:
95820
CAPACITY:46CENSUS: 15DATE:
03/01/2023
UNANNOUNCEDTIME BEGAN:
12:10 PM
MET WITH:Rowena CamillerTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Staff handled day care child in an inappropriate manner
INVESTIGATION FINDINGS:
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On March 1, 2023 at 12:10 PM, Licensing Program Analyst (LPA) Tanya Washington met with Facility Representative Rowena Camiller to deliver complaint finding regarding the allegation above. Upon arrival LPA observed five staff providing care and supervision to fifteen children inside the main classroom.

Reporting Party alleged that daycare child's g-tube was dislodged due to staff roughly changing the child's clothing during a potty accident. It was reported that this incident was observed by other staff.
During the course of the investigation LPA conducted interviews with staff, Reporting Party, parents of currently enrolled children and some children in care. LPA also made observations and conducted records review. Facility self-reported this particular incident on 01/25/2023.
During the interviews with staff, LPA learned that Staff #1 was changing Child #1 in the restroom, and no other staff witnessed Staff #1 changing Child #1.

Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
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-20230126133742
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: SHILOH ARMS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 340306418
VISIT DATE: 03/01/2023
NARRATIVE
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Staff and children's interviews did not raise any concern about Staff #1 mishandling children. LPA received conflicting information regarding this incident. Although Staff #1 may have handled Child #1 in an inappropriate manner, there was not enough evidence to support that Child #1's g-tube dislodged due to rough handling. The preponderance of evidence standard has not been met, therefore, the allegation is determined to be unsubstantiated.

There were no Title 22 deficiencies during today’s investigation. LPA reviewed this report with the Facility Representative and provided a Notice of Site Visit that must be posted for 30 days. Appeal Rights provided.
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 03/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/01/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2