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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343617215
Report Date: 03/22/2022
Date Signed: 03/22/2022 03:26:51 PM

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
01/21/2022 and conducted by Evaluator Jan Hoshida
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220121160049
FACILITY NAME:KELLI'S PALS PRESCHOOL & DAY CAREFACILITY NUMBER:
343617215
ADMINISTRATOR:BOYD, LINFACILITY TYPE:
850
ADDRESS:501 SAN JUAN ROADTELEPHONE:
(916) 922-0724
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY:56CENSUS: 19DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Lin BoydTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Facility is operating out of ratio
INVESTIGATION FINDINGS:
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On Wednesday, 03/22/22, Licensing Program Analysts (LPAs) Jan Hoshida and Edwin Tjhia conducted an unannounced inspection to the facility. The purpose of the inspection is to conclude the complaint investigation of the above allegation and deliver findings. LPA met with the Owner Lin Boyd. Upon arrival, LPA observed 16 children supervised by two staff.

The complaint alleged that facility is operating out of ratio.

During the 02/02/22 inspection, LPA observed that 19 children were in the classroom areas supervised by one staff while the other staff went to open the front door which is in another room. LPA learned that when someone comes to the front door, one staff member has to leave the room of children to go and open the locked front door which is in another room.

REPORT CONTINUED ON NEXT PAGE
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
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 5
Control Number 03-CC-20220121160049
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: KELLI'S PALS PRESCHOOL & DAY CARE
FACILITY NUMBER: 343617215
VISIT DATE: 03/22/2022
NARRATIVE
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Based on LPA's interviews and observations, the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. Title 22 deficiencies are cited on the subsequent pages of this report.

LPA Jan Hoshida informed licensee Lin Boyd that this report dated 03/22/22 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Jan Hoshida informed the licensee to provide a copy of this licensing report dated 03/22/22 that documents any Type A citation 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 the child's file for verification.

The report was reviewed with the Owner and an exit interview was conducted.

Notice of site visit to be posted for 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 03-CC-20220121160049
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: KELLI'S PALS PRESCHOOL & DAY CARE
FACILITY NUMBER: 343617215
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/23/2022
Section Cited
CCR
101216.3(a)
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There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance, except as specified in (b) and (c) below.

This was not met by evidenced by: LPA observed that 19 children were in the classroom areas supervised by one staff
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Owner stated that they have a specific office staff that is responsible to open the door to ensure that teachers do not have to leave the classroom.

LPA will return to clear citation.
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while the other staff went to open the front door which is in another room.

This is an 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: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
01/21/2022 and conducted by Evaluator Jan Hoshida
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220121160049

FACILITY NAME:KELLI'S PALS PRESCHOOL & DAY CAREFACILITY NUMBER:
343617215
ADMINISTRATOR:BOYD, LINFACILITY TYPE:
850
ADDRESS:501 SAN JUAN ROADTELEPHONE:
(916) 922-0724
CITY:SACRAMENTOSTATE: CAZIP CODE:
95834
CAPACITY:56CENSUS: 19DATE:
03/22/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Lin BoydTIME COMPLETED:
03:40 PM
ALLEGATION(S):
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Staff yell at day care children
Food services inadequate
Unqualified staff supervising day care children
Day care children are left unattended while in care
Napping equipment is unsanitary

INVESTIGATION FINDINGS:
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On Wednesday, 03/22/22, Licensing Program Analysts (LPAs) Jan Hoshida and Edwin Tjhia conducted an unannounced visit to the facility. The purpose of the inspection is to conclude the complaint investigation of the above allegations and deliver findings. LPA met with the Owner Lin Boyd. Upon arrival, LPA observed 16 children supervised by two staff.

The complaint alleged that staff yell at day care children, food services are inadequate, unqualified staff are supervising day care children, day care children are left unattended while in care, napping equipment is unsanitary.

Based on interviews, staff may have had disagreements with each other during program, but it was not deemed inappropriate or considered a violation of personal rights. Based on staff interviews, for discipline staff will talk to children about how to be respectful to each other. Based on parent interviews, there were no concerns with how the staff discipline or speak to their children.

REPORT CONTINUED ON NEXT PAGE
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 03-CC-20220121160049
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: KELLI'S PALS PRESCHOOL & DAY CARE
FACILITY NUMBER: 343617215
VISIT DATE: 03/22/2022
NARRATIVE
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Based on interviews and observations, there is adequate amount of food for the children while in care and children are able to have seconds when they want. Based on interviews, document review and observations, fully-qualified staff are supervising day care children. Based on interviews and observations, day care children are not left unattended while in care. Based on interviews and observations, napping equipment is cleaned on a regular basis prior to being put away.

Although the above alleged violations may have happened or is valid, there is not a preponderance of evidence to fully prove or disprove that the alleged violations did or did not occur; therefore, the allegations are unsubstantiated.

The report was reviewed with the Owner and an exit interview was conducted.

Notice of site visit to be posted for 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Jan Hoshida
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5