<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393615424
Report Date: 11/16/2023
Date Signed: 11/16/2023 01:07:48 PM

Substantiated


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
11/13/2023 and conducted by Evaluator David Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20231113160031
FACILITY NAME:GRIGSBY EARLY CARE AND LEARNING CENTERFACILITY NUMBER:
393615424
ADMINISTRATOR:MAHOGANY BINDERFACILITY TYPE:
850
ADDRESS:6600 GRIGSBY PLACETELEPHONE:
(209) 952-9334
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY:57CENSUS: 27DATE:
11/16/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Mahogany BinderTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff did not provide adequate supervision, resulting in day care child sustaining an injury.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 16th, 2023, at 9:30 AM, Licensing Program Analyst (LPA) David Nguyen and Licensing Program Manager (LPM) Chayntel Hunter met Director Mahagony Binder for the purpose of initiating and closing a complaint investigation. LPA disclosed the purpose of the inspection and was granted entrance. LPA toured the facility and observed twenty-seven (27) children being supervised by five (5) adults.

During the course of the investigation, LPA Nguyen conducted interviews with the Director, teachers, child, and Reporting Party. In addition, LPA obtained information pertaining to the allegation and observed the care and supervision of the daycare children. It was alleged that “Staff did not provide adequate supervision, resulting in day care child sustaining an injury.”

Based on interviews conducted it was determined that the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. The following Title 22 Deficiency is being cited on the subsequent 9099-D page.

----Report continues on subsequent page LIC 9099

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
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-20231113160031
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: GRIGSBY EARLY CARE AND LEARNING CENTER
FACILITY NUMBER: 393615424
VISIT DATE: 11/16/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director. A notice of site visit was provided and must remain posted for 30 days. Director's signature on this form acknowledges receipt of this form. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

In the areas that were evaluated, one (1) type A deficiency was cited during today’s inspection.


LPA Nguyen informed Director, Mahagony Binder that this report dated November 16th, 2023 documents one (1) Type A citation which shall be posted for 30 consecutive days as there are immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Nguyen informed the Director to provide a copy of this licensing report dated November 16th, 2023 that documents any Type A citations 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.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20231113160031
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: GRIGSBY EARLY CARE AND LEARNING CENTER
FACILITY NUMBER: 393615424
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/17/2023
Section Cited
CCR
101229(a)(1)
1
2
3
4
5
6
7
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.

(1) No child(ren) shall be left without the supervision of a teacher at any time, … Supervision shall include visual observation.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Staff Meeting will be held to focus on Supervision. Director will email LPA the sign-in sheet from this meeting. Director will create a written statement for staff to sign that describes supervision policy and procedures will be expected of staff for the future.
8
9
10
11
12
13
14
Based on interviews conducted, it was revealed that facility staff provided inadequate supervision while the children were in their care. This poses an immediate health, safety, or personal rights risk to children in care.
8
9
10
11
12
13
14
Director will email the signed statements to LPA.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 11/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/16/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3