340320556-9-7-2023-53-CC-BENN-CVKK9T-20230911074251

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 340320556
Report Date: 09/07/2023
Date Signed: 09/07/2023 03:26:58 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
07/10/2023 and conducted by Evaluator Jennie Tedlos

COMPLAINT CONTROL NUMBER: 53-CC-20230710095839

FACILITY NAME:	ST. PETER'S LUTHERAN SCHOOL		FACILITY NUMBER:	340320556
ADMINISTRATOR:	DORIS DAHLE		FACILITY TYPE:	850
ADDRESS:	8701 ELK GROVE-FLORIN ROAD		TELEPHONE:	(916) 689-3050
CITY:	ELK GROVE	STATE: CA	ZIP CODE:	95624
CAPACITY:	60	CENSUS: 41	DATE:	09/07/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Doris Dahle		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Admission Agreement: Staff inappropriately disciplined a daycare child
Reporting Requirements: Staff did not provide Incident Report to Daycare Child's Representative

INVESTIGATION FINDINGS:

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On 9/7/23 Licensing Program Analyst (LPA), Jennie Tedlos, and Licensing Program Manager (LPM), Bettina Engelman, met with Director, Doris Dahle to deliver the findings of the complaint investigation regarding the above allegations. LPA toured the facility and observed 41 children being supervised by 7 staff members.

During the course of the investigation, LPA Tedlos conducted interviews, and collected additional pertinent information, which was reviewed to assist with the investigation. The complainant alleged that staff inappropriately disciplined a daycare child by suspending the child from care for 1 week. The complainant also also alleged that staff did not provide the child’s representative with a report of a prior incident. The incidents were alleged to have taken place in July 2023 and October 2022 . Today, licensing staff observed the care and...

Report continues onto LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

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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Control Number 53-CC-20230710095839

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: ST. PETER'S LUTHERAN SCHOOL	FACILITY NUMBER: 340320556
	VISIT DATE: 09/07/2023

NARRATIVE

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supervision of children, reviewed records and conducted interviews with staff members that were present the day of the incidents. Interviews revealed that Child #1 was sent home after behavioral problems in the classroom that the staff deemed unsafe for both Child #1 and the other children in care. The decision was made by upper management to release the child from the facility's care for 1 week and a meeting was held with the staff and the complainant about the decision. The facility's Parent Handbook includes a policy stating that children can be suspended for an unspecified amount of time for serious offences. LPA learned that the complainant was notified verbally of the prior incident in October as the incident was occurring.

Based on the information obtained throughout the course of this investigation the above allegations could not be substantiated or dismissed. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the finding is UNSUBSTANTIATED.

In the areas that were evaluated, no deficiencies were cited as a result of the complaint investigation.

An Exit Interview was conducted in which the report was reviewed and discussed with Director. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Jennie Tedlos
LICENSING EVALUATOR SIGNATURE:	DATE: 09/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/07/2023

LIC9099 (FAS) - (06/04)

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