393612087-10-1-2024-53-CC-BENN-D9NTJU-20241002144652

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 393612087
Report Date: 10/01/2024
Date Signed: 10/01/2024 01:18:22 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. 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
07/22/2024 and conducted by Evaluator Corina Beckby

COMPLAINT CONTROL NUMBER: 53-CC-20240722091545

FACILITY NAME:	TENDER LOVING CARE		FACILITY NUMBER:	393612087
ADMINISTRATOR:	CHARLA B. & KRISTINA L.		FACILITY TYPE:	850
ADDRESS:	1219 WHISPERING WIND DRIVE		TELEPHONE:	(209) 832-2990
CITY:	TRACY	STATE: CA	ZIP CODE:	95377
CAPACITY:	72	CENSUS: 18	DATE:	10/01/2024
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Charla Bandy		TIME COMPLETED:	01:45 PM

ALLEGATION(S):

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1. Admission Agreement- Facility failed to follow termination policy in Admission Agreement
2. Personal Rights – Facility failed to support the needs of child in care
3. Reporting Requirements- Facility did not submit LIC 624 after sons’ finger was smashed by door
4. Lack of supervision- Staff did not provide adequate supervision resulting in childs finger getting injured

INVESTIGATION FINDINGS:

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On October 1, 2024, Licensing Program Analyst (LPA) Corina Beckby met with Facility Representatives Charla Bandy and Kristi Larsen Partyto deliver the findings of the complaint investigation regarding the above allegations.

During the course of the investigation, LPA Beckby conducted interviews, obtained and reviewed information pertaining to allegations, and observed classrooms. It was alleged facility failed to follow termination policy in Admission Agreement, facility failed to support the needs of child in care, facility did not submit LIC 624 after sons’ finger was smashed by door, staff did not provide adequate supervision resulting in childs finger getting injured.

CONTINUED ON LIC9099-C...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

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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Control Number 53-CC-20240722091545

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: TENDER LOVING CARE	FACILITY NUMBER: 393612087
	VISIT DATE: 10/01/2024

NARRATIVE

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The facility has a discipline policy and “termination of enrollment due to behavior” policy in parent handbook. Reporting Party (RP) signed stating they would abide and follow all policies. The facility staff worked with the family of Child#1 on several solutions, including moving the child to another classroom. Child#1’s finger got caught on a door resulting in an injury; however, without any medical records provided by RP, there is no proof Child#1 received medical treatment specifically for this incident. A staff stated Child#1’s mother said she took her son for a regular checkup and the doctor asked about the finger. Doctor said to keep it dry. There are inconsistencies where the incident occurred. RP and Director say it was with a classroom door. Two staff members who were supervising Child#1 said it happened in the bathroom. One staff said it was with the bathroom door, the other said she’s not sure if it was the bathroom door or the door to a stall. Child#1 was not outside alone as RP claimed.

Based on lack of clear corroborating evidence, the above allegations could not be substantiated or dismissed. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the findings are UNSUBSTANTIATED.

An exit interview was conducted in which the report was reviewed and discussed with the facility representatives, Charla Bandy and Kristi Larsen. LPA provided a copy of the report and Appeal Rights to Licensee. A Notice of Site Visit was posted by LPA and Licensee understands it must remain posted for 30 days. A Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:	DATE: 10/01/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/01/2024

LIC9099 (FAS) - (06/04)

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