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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393623001
Report Date: 01/20/2023
Date Signed: 01/20/2023 11:37:33 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
12/13/2022 and conducted by Evaluator Stacey Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20221213105453
FACILITY NAME:SHWETHA,SHWETHAFACILITY NUMBER:
393623001
ADMINISTRATOR:SHWETHA,SHWETHAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 666-0777
CITY:MOUNTAIN HOUSESTATE: CAZIP CODE:
95391
CAPACITY:14CENSUS: 12DATE:
01/20/2023
UNANNOUNCEDTIME BEGAN:
09:52 AM
MET WITH:Shwetha ShwethaTIME COMPLETED:
11:30 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
License:
Licensee operating out of ratio.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On January 20, 2023 Licensing Program Analyst (LPA) Stacey Williams arrived at the facility for the purpose of delivering complaint findings. LPA met with Licensee. LPA observed 12 preschool aged children supervised by Licensee and her Assistant. Criminal record clearances were verified.

LPA conducted an investigation regarding the allegation listed above. The facility was toured and interviews were conducted with the Licensee, children attending the Licensee's program and parents of children in the program. Additional pertinent documentation was received to assist with the investigation. Licensee denied the allegation and reported that her husband is her Assistant for the childcare program and ratio is met at all times. The facility roster was reviewed. The facility was visited during the investigation where the Licensee was operating within ratio. The reporting party is anonymous with no contact information provided, therefore LPA was unable to conduct an interview to discuss the allegation. Based on the evidence received, the allegation is determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove the alleged violation did or did not occur.

No Title 22 deficiencies have been cited for this complaint.

An Exit Interview was conducted in which the report was reviewed and discussed with Licensee,Shwetha Shwetha. Appeal rights 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.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 01/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2023
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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