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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343620599
Report Date: 01/16/2024
Date Signed: 01/16/2024 03:00:46 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
11/20/2023 and conducted by Evaluator Gagandeep Singh
COMPLAINT CONTROL NUMBER: 03-CC-20231120165545
FACILITY NAME:DOLAR, PRISCILLAFACILITY NUMBER:
343620599
ADMINISTRATOR:DOLAR, PRISCILLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 515-2030
CITY:SACRAMENTOSTATE: CAZIP CODE:
95835
CAPACITY:14CENSUS: DATE:
01/16/2024
UNANNOUNCEDTIME BEGAN:
02:30 AM
MET WITH:Priscilla DolarTIME COMPLETED:
03:30 AM
ALLEGATION(S):
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Uncleared adult has access to children while in care.
INVESTIGATION FINDINGS:
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Licensig Program Analyst (LPA) Gagandeep Singh met with the licensee, Priscilla Dollar, to deliver the findings of the above allegation.

During the investigation, LPA inspected the facility and conducted the interviews. Based on the information collected, it was found that an adult helped the licensee to setup the day care area in the mornings while the children were being dropped off. The adult did not provide direct supervision or service to the children, but was present at the facility for approximately 30 minutes, while children were present. During the record review, it was found that the adult do not have criminal background clearance on file. Based on the information collected, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations are being cited on the attached LIC 9099D. Copy of this report, notice of site visit, apeal rights and LIC9224 form were provided to the licensee.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
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 2
Control Number 03-CC-20231120165545
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: DOLAR, PRISCILLA
FACILITY NUMBER: 343620599
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/17/2024
Section Cited
CCR
102370(d)(1)
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All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility:
Obtain a California clearance or a criminal record exemption as required by the Department
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Since previous inspection, the adult helper, Jillian Song, has obtained the criminal background clearance through live scan process.
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This requirement is not met as evidenced by it was found that an adult, Jillian Song, was present at the facility while children were present and did not had criminal background clearance on file. This poses an immediate health and safety risk to 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: Natalie Dunaway
LICENSING EVALUATOR NAME: Gagandeep Singh
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2