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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393622103
Report Date: 05/09/2024
Date Signed: 05/09/2024 11:14:51 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
03/22/2024 and conducted by Evaluator Carla Polanco Rivera
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240322113950
FACILITY NAME:TEAM CHARTER BIANCHI PRESCHOOLFACILITY NUMBER:
393622103
ADMINISTRATOR:KALEY BURKEFACILITY TYPE:
850
ADDRESS:1016 EAST BIANCHI ROADTELEPHONE:
(209) 279-5502
CITY:STOCKTONSTATE: CAZIP CODE:
95210
CAPACITY:24CENSUS: 13DATE:
05/09/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ernesto PinedaTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Reporting Requirements
INVESTIGATION FINDINGS:
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On 5/9/24, Licensing Program Analysts (LPAs) Carla Polanco and Elizabeth Santiago met with licensee representative, Ernesto Pineda, to deliver the findings of the above complaint investigation.

According to the complaint, facility staff failed to report an unusual incident. Specifically, it was alleged that the facility failed to report that a child got hurt while in care. During the investigation, LPA conducted interviews with staff which revealed that an incident involving a child getting hurt while in care was not reported to child’s guardians nor to the Department of Licensing.

Licensee representative stated that moving forward any incident would be reported to the corresponding parties. Based on LPA interviews, file review and observations the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. Title 22 deficiency was cited on a subsequent 9099-D page.
Appeal Rights and Acknowledgement of Receipt of Licensing Reports provided. Notice of Site Visit posted. An exit interview was conducted in which the report was reviewed and discussed with licensee.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
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-20240322113950
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 BIANCHI PRESCHOOL
FACILITY NUMBER: 393622103
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/16/2024
Section Cited
CCR
101212(d)(1)(c)
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101212(d) Upon the occurrence...center.. below, a report shall be made to the Department … information …Department within seven days following the..such event. (1) Events reported.. following: (C) Any unusual incident or child absence that.. of any child.
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Facility Director stated that staff will be required to watch Licensing videos on Reporting requirements.
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as evidenced by:
Based on staff interviews. Facility self-desclosed to LPA that an incident was not reported to the child's guardian and Licensing Department.
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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: Karyn Guerra
LICENSING EVALUATOR NAME: Carla Polanco Rivera
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2