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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393621963
Report Date: 08/01/2024
Date Signed: 08/01/2024 12:10:04 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
07/25/2024 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240725162748
FACILITY NAME:TEAM CHARTER SCHOOLFACILITY NUMBER:
393621963
ADMINISTRATOR:LEE MCCOWANFACILITY TYPE:
850
ADDRESS:600 E MAIN STREETTELEPHONE:
(209) 462-2282
CITY:STOCKTONSTATE: CAZIP CODE:
95202
CAPACITY:30CENSUS: 5DATE:
08/01/2024
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Sophea RosTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Physical plant-Facility does not maintain a safe play structure
INVESTIGATION FINDINGS:
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On 08/01/24, Licensing Program Analysts (LPAs) Elvira Sierra and Stacey Williams conducted an unannounced visit for the purpose of a complaint investigation inspection for the above allegation and met with Program Director, Sophea Ros and Site Supervisor, Ernesto Pineda. Present in the facility were four staff supervising five children.
It was alleged facility does not maintain a safe play structure due to a broken slide. During the course of the investigation interviews were conducted with staff, documents were reviewed, and LPAs inspected the playground. LPAs inspected the play equipment and observed a broken slide attached to the play structure. Interviews and documents reviewed revealed that slide has been broken for several months. Site Supervisor stated that facility submitted a request for repairs to maintenance and manufacturer have been contacted for replacement. Based on interviews with staff and observations, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Deficiency cited on attached LIC 9099D page. Exit interviewed conducted. This report and Appeal of Rights were reviewed and provided to Site Supervisor Ernesto Pineda and Program Director, Sophea Ros. Notice of Site Visit posted.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
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 2
Control Number 53-CC-20240725162748
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: TEAM CHARTER SCHOOL
FACILITY NUMBER: 393621963
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/09/2024
Section Cited
CCR
101239(o)(1)
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101239 Fixtures, Furniture, Equipment and Supplies. (o)Playground equipment shall be securely anchored to the ground unless it is portable by design. (1) Equipment shall be maintained in a safe condition, free of sharp, loose or pointed parts.
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POC; During the inspection broken slide was removed from the play structure.
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This requirement was not met as evidence by; Interviews and observation revealed that play structure slide has been broken for a few months now. This is a deficiency that if no corrected can pose a risk to the health and safety of the children 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: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2