343617215-9-23-2022-03-CC-NDUY-CJPLHQ-20220928084639

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343617215
Report Date: 09/23/2022
Date Signed: 09/23/2022 09:29:43 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
08/17/2022 and conducted by Evaluator Kelly Ferrara

PUBLIC

COMPLAINT CONTROL NUMBER: 03-CC-20220817093146

FACILITY NAME:	KELLI'S PALS PRESCHOOL & DAY CARE		FACILITY NUMBER:	343617215
ADMINISTRATOR:	BOYD, LIN		FACILITY TYPE:	850
ADDRESS:	501 SAN JUAN ROAD		TELEPHONE:	(916) 922-0724
CITY:	SACRAMENTO	STATE: CA	ZIP CODE:	95834
CAPACITY:	56	CENSUS: 12	DATE:	09/23/2022
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Kelli Lopez		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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Staff did not properly supervise day-care child which resulted in injuries to a child.
Staff left day-care child in soiled diaper for extended period of time

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kelly Ferrara conducted a complaint follow up inspection to deliver findings and met with Facility Representative Kelli Lopez. LPA observed there were currently 12 children in care with three staff. During the investigation, LPA obtained relevant documentation and interviewed Reporting Party, Director and staff. It was alleged that the staff are not providing appropriate supervision which led to a child obtaining injuries. LPA reviewed pictures of a cut on Child #1’s finger and a mark on their face. Staff stated that they were present at the time when the injuries occurred and gave the child ice. Staff stated there are generally multiple teachers in the room with the children to provide supervision. It was alleged that Child #1 was not changed for an extended period of time. Staff stated they check on the children’s diapers every one to two hours.
Based on the evidence obtained, LPA determined that the allegations are unsubstantiated, meaning that although the allegations may have happened or are valid, there is not a preponderance of evidence to prove it. Exit interview was conducted and a copy of this report was given to the Facility Representative. Notice of Site visit was provided which must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Kelly Ferrara
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022

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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