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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623185
Report Date: 08/05/2022
Date Signed: 08/05/2022 10:36:01 AM

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
07/27/2022 and conducted by Evaluator Christopher Bello
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220727103211
FACILITY NAME:SETA CP HUNTINGTON HEAD STARTFACILITY NUMBER:
343623185
ADMINISTRATOR:BELL, SABRINAFACILITY TYPE:
850
ADDRESS:5917 26TH STREETTELEPHONE:
(916) 263-3800
CITY:SACRAMENTOSTATE: CAZIP CODE:
95822
CAPACITY:36CENSUS: 8DATE:
08/05/2022
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Shannon MatlockTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff not meeting day care child’s diapering need
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Christopher Bello arrived at the facility at approximately 9:40am and met with Director Shannon Matlock to open and close a complaint investigation. Upon arrival, LPA observed eight Children with eight teachers. LPA made observations, gathered documents pertaining to the investigation and conducted interviews. It was alleged that a child#1's diaper was not changed all day by staff#1 because the child would scratch whenever a diaper change was attempted. Director stated that they have conducted training for all of the staff and gave staff#1 a write-up to ensure that it does not happen again. Director also stated that staff#1 no longer works for the facility. Based on LPAs' investigation, the preponderance of evidence standard has been met, therefore, the above allegations are found to be substantiated.

Title 22 deficiencies are cited on the subsequent page of this report. Type Acknowledgement forms are to be signed by current parent of the facility and new parents for the next twelve months. LIC 9224 and Appeal Rights were provided. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Roxana Saravia
LICENSING EVALUATOR NAME: Christopher Bello
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
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-20220727103211
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: SETA CP HUNTINGTON HEAD START
FACILITY NUMBER: 343623185
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/06/2022
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 functions of daily living including eating, sleeping or toileting; or
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Director has conducted staff training. Staff#1 was written up and no longer works for the facility. LPA cleared the deficiency.
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withholding of shelter, clothing, medication or aids to physical functioning. This requirement has not been met by evidence" Staff#1 did not change a child#1's diaper for six hours due to the child scratching when attempting a diaper change. This is considered as an immediate risk to the 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: Christopher Bello
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2