343616736-10-27-2022-03-CC-SDLA-CKMSGP-20221028135216

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343616736
Report Date: 10/27/2022
Date Signed: 10/27/2022 10:22:24 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
08/01/2022 and conducted by Evaluator Amanda Sutter

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220801105932

FACILITY NAME:	CALVARY CHRISTIAN PRESCHOOL		FACILITY NUMBER:	343616736
ADMINISTRATOR:	ARRIAGA, SUSAN		FACILITY TYPE:	850
ADDRESS:	4911 47TH AVENUE		TELEPHONE:	(916) 393-3633
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95824
CAPACITY:	40	CENSUS: 18	DATE:	10/27/2022
		UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Hope Camarena		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Day-care children sustained injuries while in care
Day care children are being bit by another child in care
Facility sign in and out sheets are inaccurate
Child was left in a soiled diaper for a long period of time
Staff handled child in a rough manner
Day-care children’s information was not kept confidential
Facility did not provide child’s records to responsible party
Staff use other children’s bedding during naptime
Teacher assistant is not immunized.

INVESTIGATION FINDINGS:

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On Thursday, October 27, 2022, Licensing Program Analysts (LPA) Amanda Sutter and Soleil Marx met with Director Susan Arriaga to deliver findings regarding the above allegations. LPA observed 18 children supervised by 3 staff. The following are the allegations against the facility: day-care children sustained injuries while in care; day care children are being bit by another child in care; facility sign in and out sheets are inaccurate; child was left in a soiled diaper for a long period of time; staff handled child in a rough manner; day-care children’s information was not kept confidential; facility did not provide child’s records to responsible party; staff use other children’s bedding during naptime; and teacher assistant is not immunized.

CONTINUED ON LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

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 03-CC-20220801105932

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: CALVARY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 343616736
	VISIT DATE: 10/27/2022

NARRATIVE

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During previous inspections, Director provided LPA with copies of accident reports. LPA observed accident reports to be written on carbon copy paper and the yellow, copied page to be stored in each child’s file. The director stated that the original copy is given to the parents. LPA observed a total of nine accident reports in five different children’s files. The facility also makes use of “Uh-oh!” Behavioral Incident Notices to inform parents of behavioral problems. This includes biting others and aggressive behavior. LPA learned that while injuries did occur due to children biting and playing roughly, staff was present and unable to prevent the injury from occurring.

LPA observed electronic sign-in/out system and was provided with print-outs of the sign in sheet for August 10, 2022. LPA observed children on the sign in sheet to be present at the facility. LPA did not find any evidence that the sign-in/out sheets are inaccurate.

LPA was provided with a diapering log documenting times and dates for toileting and diaper changes from 9/6/2022-9/9/2022; 9/12/2022; and 10/3/2022-10/7/2022.The log shows an average of 4 diaper changes/check, or toileting checks, per child per day. During interviews, LPA learned that while children do go home with wet diapers occasionally, it is not consistent.

Based on staff and parent interviews, LPA did not find any evidence to suggest that a staff member was rough with a child. Through interviews, LPA learned that staff stated that they give children a warning followed by a time out if necessary. If behavioral issues continue, staff make use of “Uh-oh!” notices or speak to parents.

LPA reviewed behavioral reports as well as accident reports, and interviewed staff on the record keeping process. Lead Teacher stated that reports are shared with parents and that only the child who is hurt is named in the accident report. Lead teacher stated that parents are always notified in the case of visible injuries and habitual, disruptive behavior. LPA did not observe accident reports that named multiple children.

LPA interviewed Lead Teacher regarding bedding storage and usage. Lead Teacher stated that bedding is sent home with parents on Fridays to be washed or washed at the facility if parents do not take it home. Lead Teacher stated that bedding is stored individually in white bags in a cupboard and that the children’s names are written on each back. LPA observed and was provided with photos of the stored bedding.
CONTINUED ON LIC 9099-C

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 03-CC-20220801105932

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: CALVARY CHRISTIAN PRESCHOOL	FACILITY NUMBER: 343616736
	VISIT DATE: 10/27/2022

NARRATIVE

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LPA learned that the teacher assistant in question was a student volunteer. Lead Teacher stated that the volunteer had been enrolled in the school while she was volunteering but that she had left to attend a public high school. LPA was unable to access the file of the volunteer but learned through interview and file review that she had 5 immunizations prior to volunteering. LPA could not determine which vaccinations the volunteer had at the time that she volunteered.

Based on the information obtained, the above allegations are determined to be UNSUBSTANTIATED, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove it. An exit interview was conducted. Appeal rights were discussed. A notice of site visit was provided and shall remain posted for 30 days.

SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:	DATE: 10/27/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/27/2022

LIC9099 (FAS) - (06/04)

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