343623051-3-20-2023-03-CC-NDUY-CQ8TMG-20230324145108

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 343623051
Report Date: 03/20/2023
Date Signed: 03/20/2023 01:37:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
RIVER CITY (SACTO)CC, 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
01/04/2023 and conducted by Evaluator Jennifer Velasco

COMPLAINT CONTROL NUMBER: 03-CC-20230104094348

FACILITY NAME:	KIDS PARK-FOLSOM(PS)		FACILITY NUMBER:	343623051
ADMINISTRATOR:	AMIRI, AZADEH		FACILITY TYPE:	850
ADDRESS:	1111 RILEY STREET		TELEPHONE:	(916) 293-8786
CITY:	FOLSOM	STATE: CA	ZIP CODE:	95630
CAPACITY:	60	CENSUS: 12	DATE:	03/20/2023
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Administrator Ladan Shojaei Kavan		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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Daycare children are being hit while in care
Staff behavior poses as a risk to the daycare children while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst Jennifer Velasco (LPA) conducted an unannounced subsequent complaint investigation inspection and met with facility representative, Administrator Ladan Shojael Kavan (M1). LPA toured the facility, including all activity and classroom spaces, restrooms, and food service areas. Upon arrival, LPA observed 12 children in care being supervised by two classroom staff. M1 was reminded never to exceed the conditions, limitations, and capacity specified on the license. Facility hours of operation are Monday through Friday 7:30 AM - 8:00 PM, Saturday 9:00 AM - 9:00 PM, and Sunday 11:00 AM - 6:00 PM.

It was alleged facility staff hit children in care and that staff behavior poses a risk to children in care. During the investigation, LPA observed care, conducted interviews, and requested and reviewed facility documents. LPA observations, witness statements, and facility document reviews failed to corroborate the allegation that staff hit children in care and failed to corroborate that allegation that staff behavior poses a risk to children in care. The preponderance of evidence standard has not been met; therefore, the allegation is unsubstantiated.

Exit interview was conducted, appeal rights were provided, and a Notice of Site was posted and must remain posted where visible to parents for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Natalie Dunaway	TELEPHONE: (916) 263-1414
LICENSING EVALUATOR NAME: Jennifer Velasco	TELEPHONE: 707-953-7341
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2023

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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