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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343622833
Report Date: 05/21/2024
Date Signed: 05/21/2024 04:08:16 PM

Unsubstantiated


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
04/09/2024 and conducted by Evaluator Loraine Perez
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240409083223
FACILITY NAME:TAYLOR, CHAUNCYFACILITY NUMBER:
343622833
ADMINISTRATOR:TAYLOR, CHAUNCYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 904-9166
CITY:ANTELOPESTATE: CAZIP CODE:
95843
CAPACITY:14CENSUS: 5DATE:
05/21/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:TIME COMPLETED:
05:00 PM
ALLEGATION(S):
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Provider hit day care child while in care.
Provide did not give day care child water while in care.
Provider made day care child exercise while in care.
INVESTIGATION FINDINGS:
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On Tuesday, May 21, 2024, Licensing Program Analyst (LPAs) Lea Habtom and Loraine Perez met with Licensee, Chauncy Taylor, to close a complaint investigation for the above allegations. Upon arrival, LPA observed 5 children being supervised by Licensee.

Provider hit day care child while in care.

During the investigation, LPA Loraine Perez toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that the provider hit a day care child while in care. Due to the limited information collected regarding the allegation, LPA L. Perez determined that personal rights the allegation the licensee violated a child’s personal rights by hitting a child to be UNSUBSTANTIATED. Although it may or may have not happened, there is not a preponderance of the evidence to prove that the alleged violations occurred.

This report is continued on 9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
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-20240409083223
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: TAYLOR, CHAUNCY
FACILITY NUMBER: 343622833
VISIT DATE: 05/21/2024
NARRATIVE
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Provide did not give day care child water while in care.

During the investigation, LPA Loraine Perez toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that the provider did not give day care children water. Due to the limited information collected regarding the allegation, LPA L. Perez determined that the personal rights allegation that the licensee did not give day care children water to be UNSUBSTANTIATED. Although it may or may have not happened, there is not a preponderance of the evidence to prove that the alleged violations occurred.

Provider made day care child exercise while in care.

During the investigation, LPA Loraine Perez toured the facility, conducted observation, and interviewed those pertinent to the investigation. It was alleged that the provider made day care children exercise. Due to the limited information collected regarding the allegation, LPA L. Perez determined that the personal rights allegation that the licensee made day care children exercise to be UNSUBSTANTIATED. Although it may or may have not happened, there is not a preponderance of the evidence to prove that the alleged violations occurred.

No Title 22 regulations were cited with this inspection. This report was reviewed with licensee, Chauncy Taylor. A notice of site visit was provided to be posted for 30 days. Appeal rights provided.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Loraine Perez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2