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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393612245
Report Date: 11/18/2022
Date Signed: 11/18/2022 11:49:27 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 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
10/13/2022 and conducted by Evaluator Lauren Scott
COMPLAINT CONTROL NUMBER: 53-CC-20221013145954
FACILITY NAME:LOVINS, KIMBERLYFACILITY NUMBER:
393612245
ADMINISTRATOR:LOVINS, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 838-8963
CITY:ESCALONSTATE: CAZIP CODE:
95320
CAPACITY:14CENSUS: 8DATE:
11/18/2022
UNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:licensee, Kimberly LovinsTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Staff not providing adequate supervision to child(ren) in care.
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs) Lauren Scott and Tobias Lake met with licensee, Kimberly Lovins to deliver the findings of the complaint investigation regarding the above allegation.
During the course of the investigation, LPA Scott conducted interviews, and obtained information pertaining to allegation. It was alleged that a child wandered away from the facility while in care. It was alleged the child was found down the street by a neighbor. The child was escorted back to the facility by the neighbor as well.

Based on the interviews and review of records that revealed this event did take place. The preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Title 22 regulations are being cited on the attached 9099-D page.

Report continues on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
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 3
Control Number 53-CC-20221013145954
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME: LOVINS, KIMBERLY
FACILITY NUMBER: 393612245
VISIT DATE: 11/18/2022
NARRATIVE
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LPA Scott informed licensee, Kimberly Lovins, that this report dated November 18, 2022, documents one Type A citation. Type A citations which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Scott informed the licensee to provide a copy of this licensing report dated November 18, 2022, that documents the one Type A citation 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.

An exit interview was conducted with the licensee. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20221013145954
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: LOVINS, KIMBERLY
FACILITY NUMBER: 393612245
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/18/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/18/2022
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home. (a) the licensee shall be present... and shall ensure that children in care are supervised at all times. This requirement was not met by evidenced by:
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Licensee stated she is no longer using the front yeard (unfenced area) as an outside play area for the children. Licensee is only allowing children to play outside in the fenced backyard
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Based on interviews conducted, it was determined C1 wandered away from the facility, and turned the corner of the licensee's street onto another street and located by a neighbor. This is an immediate health and safety risk to children in care.
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IMMEDIATE CIVIL PENALTY IN THE AMOUNT OF $500 IS ASSESSED
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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: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 11/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/18/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3