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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 340319878
Report Date: 04/06/2022
Date Signed: 04/07/2022 09:59:46 AM

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
02/23/2022 and conducted by Evaluator Michelle Pascual
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220223160532
FACILITY NAME:B J JORDAN CHILD CARE - JEFFERSONFACILITY NUMBER:
340319878
ADMINISTRATOR:HAYWOOD, ELIZABETHFACILITY TYPE:
850
ADDRESS:2001 PEBBLEWOOD DRIVETELEPHONE:
(916) 920-8188
CITY:SACRAMENTOSTATE: CAZIP CODE:
95833
CAPACITY:25CENSUS: 7DATE:
04/06/2022
UNANNOUNCEDTIME BEGAN:
08:10 AM
MET WITH:Shanon RileyTIME COMPLETED:
10:00 AM
ALLEGATION(S):
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Personal Rights- Child's toileting needs were not met & Child was not accorded dignity in his/her personal relationships with staff
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Michelle Pascual met with Facility Representative Shanon Riley on April 6th approximately at 08:25am to deliver complaint finding for the allegations mentioned above. LPA observed seven children in care being supervised by three staff including the Site Supervisor.

It was alleged that children’s toileting needs were not met and that they were not accorded dignity in their personal relationships with staff. LPA investigated the complaint through interviews with the Director of all Beanstalk programs, the supervisor of all of the centers, Site Supervisor, a teacher’s aide, children and the reporting party. LPA found through staff interviews that there were some issues with a child. Staff explained the steps they have taken to find resolve for the situation as they were concerned for the safety of other children in care. LPA witnessed all children afforded dignity with staff as well as toileting needs being addressed through multiple site visits.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE:

DATE: 04/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2022
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-20220223160532
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: B J JORDAN CHILD CARE - JEFFERSON
FACILITY NUMBER: 340319878
VISIT DATE: 04/06/2022
NARRATIVE
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Based on the information obtained, LPA was not able to determine that children were not afforded dignity in personal relationships with staff and could not determine that toileting needs were not met. Therefore, the allegation is determined to be unsubstantiated, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it. An exit interview was conducted.

Notice of site visit and appeal rights were also addressed. The Notice of site visit shall remain posted for 30 days for guardian/parental review.
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Michelle Pascual
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2