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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343616542
Report Date: 09/15/2022
Date Signed: 09/15/2022 10:09:39 AM

Substantiated


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
09/13/2022 and conducted by Evaluator Karyn Guerra
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220913112643
FACILITY NAME:SAN JUAN PRE-SCHOOLFACILITY NUMBER:
343616542
ADMINISTRATOR:LEWIS, JENNYFACILITY TYPE:
850
ADDRESS:7413 WISCONSIN DRIVETELEPHONE:
(916) 863-0337
CITY:CITRUS HEIGHTSSTATE: CAZIP CODE:
95610
CAPACITY:24CENSUS: 14DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
08:55 AM
MET WITH:Savannah ButlerTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Facility is operating out of ratio
INVESTIGATION FINDINGS:
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At 8:55 a.m. on Thursday, September 15th, 2022, Licensing Program Analysts (LPAs) Karyn Guerra and Matthew Gallo met with Staff, Savannah Butler, for the prupose of an unannounced complaint inspection. It was alleged that the facility is operating out of ratio. Throughout the course of the investigation, LPAs conducted interviews and made observations. A census was conducted upon arrival at 8:55 a.m. at which time 14 preschool children were observed on the outdoor play yard with 1 staff (S1). It was stated in an interview that there was a teacher who quit the day prior. At 9:33 a.m., a substitute staff from the sister location arrived to support the infant facility, allowing an aide without units to support the preschool. The preponderance of evidence standard has been met, and the allegation is substantiated.

report continued on 9099-D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
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 3
Control Number 03-CC-20220913112643
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: SAN JUAN PRE-SCHOOL
FACILITY NUMBER: 343616542
VISIT DATE: 09/15/2022
NARRATIVE
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Title 22 deficiencies are cited on the subsequent pages of this report. Staff acknowledges, that FOR TYPE A DEFICIENCIES ONLY upon receipt, licensee shall post LIC 9099D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. LIC 9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the licensee. LIC 9224 and Appeal Rights were provided. Staff's signature on this report acknowledges receipt of these rights. This report was reviewed with the Staff, Savannah Butler. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 03-CC-20220913112643
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: SAN JUAN PRE-SCHOOL
FACILITY NUMBER: 343616542
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/16/2022
Section Cited
CCR
101216.3(a)
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(a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance...This requirement was not met, as evidenced by:
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During inspection, a substitute staff arrived from the sister location and supervised the infant facility, allowing for two staff to supervise preschool. A follow up inspection will be conducted to clear the citation.
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Based on observation, the facility was operating out of ratio, as one teacher was alone with 14 children. This poses an immediate risk to the health and safety of 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: Seychelle De Luca
LICENSING EVALUATOR NAME: Karyn Guerra
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3