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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393621652
Report Date: 07/09/2024
Date Signed: 07/09/2024 11:54:51 AM

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
06/21/2024 and conducted by Evaluator David Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240621141528
FACILITY NAME:COUNTRY CLUB EARLY CARE & LEARNING CENTERFACILITY NUMBER:
393621652
ADMINISTRATOR:VERONICA GONZALEZFACILITY TYPE:
850
ADDRESS:2448 COUNTRY CLUB BOULEVARDTELEPHONE:
(209) 941-9100
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:72CENSUS: 38DATE:
07/09/2024
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Veronica GonzalezTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Personal Rights: Staff handle children in a rough manner.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), David Nguyen and Licensing Program Manager (LPM), Chayntel Hunter conducted an unannounced field visit to deliver the findings for the above allegation. Both LPA and LPM arrived at the facility and was met by Director Veronica Gonzalez (D1). LPA disclosed the purpose of the inspection and was granted entrance. LPA toured the facility and observed thirty-eight (38) childcare children being supervised by ten (10) childcare teachers.

It was alleged that the “Staff handle children in a rough manner.”

Report continues on LIC9099-C....
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
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 5
Control Number 53-CC-20240621141528
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: COUNTRY CLUB EARLY CARE & LEARNING CENTER
FACILITY NUMBER: 393621652
VISIT DATE: 07/09/2024
NARRATIVE
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 During the investigation LPA Nguyen toured the facility, observed staff interactions with children in care and ratios and supervision, conducted interviews with teachers, parents, children, and reporting party, and obtained pertinent documents. Based on interviews with teachers and reporting party, LPA obtained corroborating information from childcare teachers and reporting party. One individual stated that teacher picked up the childcare child in a rough manner while he played on the playground with his peers and teachers. Staff (S2) admitted to picking up C1 in a rough manner. C1 was grabbed by the teacher with both hands and then placed on the ground.

Based on corroborating information from teachers’ interviews, there is a preponderance of evidence to prove the alleged violation did occur at the facility. Therefore, the above allegation is found to be SUBSTANTIATED.

The following Title 22 Deficiency is being cited on the subsequent 9099-D page. Upon receipt of Type A citations, Director shall provide copies of the LIC 9099-D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Director must also keep the signed LIC 9224, acknowledging receipt of LIC 9099-D in each child's file.

Appeal Rights were provided, and LPA posted a Notice of Site Visit and 9099-D page dated 7/9/2024 which must remain posted for 30 days.

Copy of this report was reviewed and provided to Director. Notice of site visit is posted and shall remain posted for next 30 days.

An exit interview was conducted with Director. 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: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
06/21/2024 and conducted by Evaluator David Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240621141528

FACILITY NAME:COUNTRY CLUB EARLY CARE & LEARNING CENTERFACILITY NUMBER:
393621652
ADMINISTRATOR:VERONICA GONZALEZFACILITY TYPE:
850
ADDRESS:2448 COUNTRY CLUB BOULEVARDTELEPHONE:
(209) 941-9100
CITY:STOCKTONSTATE: CAZIP CODE:
95204
CAPACITY:72CENSUS: 38DATE:
07/09/2024
UNANNOUNCEDTIME BEGAN:
11:05 AM
MET WITH:Veronica GonzalezTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Personal Rights: Staff scream at children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), David Nguyen and Licensing Program Manager (LPM), Chayntel Hunter conducted an unannounced field visit to deliver the findings for the above allegation. Both LPA and LPM arrived at the facility and was met by Director Veronica Gonzalez (D1). LPA disclosed the purpose of the inspection and was granted entrance. LPA toured the facility and observed thirty-eight (38) childcare children being supervised by ten (10) childcare teachers.

It was alleged that “Staff scream at children in care.”

Report continues on LIC9099-C....
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 53-CC-20240621141528
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: COUNTRY CLUB EARLY CARE & LEARNING CENTER
FACILITY NUMBER: 393621652
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
08/09/2024
Section Cited
CCR
101223(a)(1)
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(1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by:
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Staff Meeting will be held to focus on Personal Rights and Behavioral Management strategies. Director will email LPA the sign-in sheet from this meeting. Director will create a written statement for staff to sign for positive discipline.
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Based on the interviews, S2 picked up C1 with both hands and placed C1 back on the ground in a rough manner which posed an immediate health, safety, or personal rights risk to children in care.
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Director will email the signed statements to LPA.
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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: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20240621141528
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: COUNTRY CLUB EARLY CARE & LEARNING CENTER
FACILITY NUMBER: 393621652
VISIT DATE: 07/09/2024
NARRATIVE
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Throughout the investigation, LPA conducted the investigation and interviewed with reporting party, childcare teachers, childcare children, and parents. During the interviews with teachers, children, and parents, no information was disclosed to support that staff scream at children in care. The interviews produced conflicting information. During record review, LPA learned that staff directed childcare children with a firm voice. Based on lack of corroborating information, the LPA is unable to determine whether staff did or did not scream at children in care.

Based on interviews and record review obtained from the reporting party, LPA David Nguyen determined that the complaint allegation was found to be UNSUBSTANTIATED, meaning although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur at the facility.



Copy of this report was reviewed and provided to Director. Notice of site visit is posted and shall remain posted for next 30 days.

An exit interview was conducted with Director and Appeal Rights were provided. 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: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5