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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623996
Report Date: 09/10/2024
Date Signed: 09/10/2024 12:10:45 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
09/06/2024 and conducted by Evaluator Amanda Sutter
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20240906150423
FACILITY NAME:HERRERA, KATHERINEFACILITY NUMBER:
343623996
ADMINISTRATOR:KATHERINE HERRERAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 598-5212
CITY:SACRAMENTOSTATE: CAZIP CODE:
95842
CAPACITY:14CENSUS: 7DATE:
09/10/2024
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Katherine HerreraTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Chemicals are accessible to children.
INVESTIGATION FINDINGS:
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On Tuesday, September 10, 2024, Licensing Program Analyst (LPA) Amanda Sutter met with Licensee Katherine Herrera to open a complaint investigation and deliver findings regarding the above allegations. LPAs observed 7 children supervised by the licensee and her assistant. It was alleged that chemicals are accessible to children at the facility.

LPA observed the facility upon arrival. In the hallway bathroom, the child lock on the cabinet under the sink to be unlocked. LPA observed a clorox spray bottle in this cabinet. LPA observed licensee lock the child lock. In the bathroom connected to the play room, LPA observed shampoo, soap, and conditioner on a low shelf that were accessible to children. These items were moved to a higher shelf inaccessible to children. Based on the above information, the allegation is substantiated.

CONTINUED ON LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
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 4
Control Number 03-CC-20240906150423
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: HERRERA, KATHERINE
FACILITY NUMBER: 343623996
VISIT DATE: 09/10/2024
NARRATIVE
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One Title 22 Deficiencies have been issued on the attached LIC 809-D. The licensee was informed that this report dated 9/10/2024 documents one Type A citation which shall be posted for 30 consecutive days. The licensee shall also provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. Licensee has been provided with appeal rights. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with Katherine Herrera.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 03-CC-20240906150423
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: HERRERA, KATHERINE
FACILITY NUMBER: 343623996
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/11/2024
Section Cited
CCR
102417(g)(4)
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102417 Operation of a Family Child Care Home (g) The home shall be free from...conditions which might endanger a child. (4) Poisons, detergents, cleaning compounds...and other items...shall be stored where they are inaccessible to children.
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LPA observed all items labeled "keep out of reach of children" to be made inaccessible to children during the inspection. Licensee stated that she was interested in TSP and will email LPA to sign up for support from a TSP analyst.
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This regulation was not met as evidenced by:
Items labeled "Keep out of reach of children" were observed to be accessible to children, which poses an immediate health, safety or personal rights risk to persons 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: Seychelle De Luca
LICENSING EVALUATOR NAME: Amanda Sutter
LICENSING EVALUATOR SIGNATURE:

DATE: 09/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4