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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343604450
Report Date: 02/11/2025
Date Signed: 02/11/2025 06:07:41 PM

Substantiated


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
02/10/2025 and conducted by Evaluator Loraine Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250210111804
FACILITY NAME:SUNRISE KIDS CLUB OLIVE GROVEFACILITY NUMBER:
343604450
ADMINISTRATOR:BERNARDI, PATRICIAFACILITY TYPE:
840
ADDRESS:7926 FIRESTONE WAYTELEPHONE:
(916) 726-0224
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:120CENSUS: 30DATE:
02/11/2025
UNANNOUNCEDTIME BEGAN:
03:05 PM
MET WITH:Kailey MortonTIME COMPLETED:
06:15 PM
ALLEGATION(S):
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Facility was not kept free of hazards for children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Loraine Perez and Matthew Gallo met with Facility Representative Kourtney Hobart, for the purpose of conducting an unannounced complaint investigation inspection pertaining to the above allegation. There is a census of 30 children in care. This investigation is opened and closed on the same inspection date.The purpose of today's inspection was explained to the Facility Representative.
It is alleged that the facility was not kept free of hazards for children in care.
During today's inspection, LPAs conducted interviews, observations, and obtained relevant documentation.
Based on LPA observation, and interviews, the facility was made aware of fungal material. The facility moved children out of the room and later the facility to another area of the elementary school campus.
The preponderance of evidence standard has been met, therefore the above allegation is SUBSTANTIATED.

Report continues on LIC9099C.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
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 3
Control Number 03-CC-20250210111804
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: SUNRISE KIDS CLUB OLIVE GROVE
FACILITY NUMBER: 343604450
VISIT DATE: 02/11/2025
NARRATIVE
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The Facility Representative was informed that this report dated 02/11/2025 documents one Type A citation and must be posted for parental review for 30 consecutive days. The facility must also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in each child's file for verification.

Exit interview was conducted and a copy of this report was given to the Facility Representative Kourtney Hobart. Notice of site was given and must remain posted for parental review for 30 days. Appeal rights were provided.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20250210111804
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: SUNRISE KIDS CLUB OLIVE GROVE
FACILITY NUMBER: 343604450
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/12/2025
Section Cited
CCR
101238(a)
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The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.
This requirement is not met as evidenced by:
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Licensee requested to have room 3 tested for mold and then all classrooms. Next a meeting with elementary principle will be scheduled to find a temporary facility or rooms to use while in the process of a qoute for repairs to the original facility. Licensee will submit an unusual incident report by the plan of correction date.
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Based on interviews and review of documentation, the facility did not comply with the section cited above by not maintaining the building used for child care in good repair to prevent the fungal material from developing. This poses a immediate risk to the health and safety of the children in care.
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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: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3