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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343621219
Report Date: 08/05/2021
Date Signed: 08/05/2021 12:40:54 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
06/14/2021 and conducted by Evaluator Tanya Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210614113013
FACILITY NAME:KING'S CHILDREN'S ACADEMYFACILITY NUMBER:
343621219
ADMINISTRATOR:KING, JOSETTEFACILITY TYPE:
850
ADDRESS:2635 EDISON AVENUETELEPHONE:
(916) 993-6510
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:49CENSUS: 10DATE:
08/05/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Alicia MedinaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff handled day care child in a rough manner
INVESTIGATION FINDINGS:
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On August 5, 2021 at 10:30 AM, Licensing Program Analysts Tanya Washington and Jeremey McClain met with head teacher Alicia Medina to deliver complaint finding for the allegation above. During today's inspection ten children were supervised by Ms. Medina and Staff #1.

During the course of the investigation LPA conducted interviews with Reporting Party, staff, children and parents of currently enrolled children. LPA also conducted observations and reviewed files.

It was alleged that when a child expressed that they were being mistreated by other children to their teacher, the teacher's response was "you deserve it". It was also alleged that Staff #2 punched Child #1 on the arm. LPA received insufficient information regarding staff hitting or hurting children.
Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
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-20210614113013
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: KING'S CHILDREN'S ACADEMY
FACILITY NUMBER: 343621219
VISIT DATE: 08/05/2021
NARRATIVE
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During the interviews it was revealed that children don't have much to do and play on their phones and tables brought from home. LPA has also learned that when younger children misbehave, hit or bite other children they are placed in a high chair for time out by Staff #1.

Based upon evidence obtained through interviews, there is a preponderance of evidence to support the allegation; therefore, the finding is SUBSTANTIATED.

Title 22 deficiency is cited on the subsequent page of this report (LIC9099D). Facility Representative acknowledges, that for TYPE A DEFICIENCIES ONLY upon receipt, facility representative shall post LIC9099-D with Type A deficiency 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. LIC9224 must be signed by parents/guardians and kept with the children's forms as a receipt whenever any Type A citation is received.

This report was reviewed with Lead Teacher. Appeal rights, LIC9224, and notice of site visit was provided during today's inspection.
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 03-CC-20210614113013
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: KING'S CHILDREN'S ACADEMY
FACILITY NUMBER: 343621219
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/06/2021
Section Cited
CCR
101223(a)(3)
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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature including but not limited to: interference with
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Director will remove high chairs from the preschool program.

Director will submit a written plan of correction to LPA Washington by 8/6/21.

tanya.washington@dss.ca.gov
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functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning. This requirement is not met as evidenced: LPAs learned that Staff #1 places children into a high chair for a time out when children misbahave, hit or bite other children. This is an immidiate 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: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
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
06/14/2021 and conducted by Evaluator Tanya Washington
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210614113013

FACILITY NAME:KING'S CHILDREN'S ACADEMYFACILITY NUMBER:
343621219
ADMINISTRATOR:KING, JOSETTEFACILITY TYPE:
850
ADDRESS:2635 EDISON AVENUETELEPHONE:
(916) 993-6510
CITY:SACRAMENTOSTATE: CAZIP CODE:
95821
CAPACITY:49CENSUS: 10DATE:
08/05/2021
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Alicia MedinaTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Staff yell at and speak inappropriately to day care children.
Facility failed to provide adequate supervision and day care child was bullied while in care.
INVESTIGATION FINDINGS:
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On August 5, 2021 at 10:30 AM, Licensing Program Analysts Tanya Washington and Jeremey McClain met with head teacher Alicia Medina to deliver complaint findings for the allegations above. During today's inspection ten children were supervised by Ms. Medina and Staff #1.

During the course of the investigation LPA conducted interviews with Reporting Party, staff, children and parents of currently enrolled children. LPA also conducted observations and reviewed files.

Interviews revealed that on occassion staff were overheard raising their voice at children, however there is not enough evidence to support that it was done in a manner that violated children's personal rights.
Continued on LIC9099C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
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-20210614113013
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: KING'S CHILDREN'S ACADEMY
FACILITY NUMBER: 343621219
VISIT DATE: 08/05/2021
NARRATIVE
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Multiple interviews revealed that on occasion children had conflicts over sharing or name calling, however there is not enough evidence to support that bullying occurs due to lack of supervision.

LPAs determined that although the allegation may have happened or valid, there is not a preponderance of evidence to prove that the alleged violation occurred.

Exit interview was conducted. Appeal rights provided. Notice of site visit posted.
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Tanya Washington
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5