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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 394500019
Report Date: 01/26/2022
Date Signed: 01/26/2022 03:17:52 PM

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
10/25/2021 and conducted by Evaluator Stacey Williams
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20211025150640
FACILITY NAME:MANE, PALLAVIFACILITY NUMBER:
394500019
ADMINISTRATOR:MANE, PALLAVIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 413-7566
CITY:MOUNTAIN HOUSESTATE: CAZIP CODE:
95391
CAPACITY:14CENSUS: 8DATE:
01/26/2022
UNANNOUNCEDTIME BEGAN:
02:39 PM
MET WITH:Pallavi Mane TIME COMPLETED:
03:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff hit day care children
Staff threaten day care children
Staff do not allow children to have water
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Stacey Williams arrived at the facility for the purpose of delivering complaint findings regarding the allegations listed above. LPA met with Licensee, Pallavi Mane. LPA observed (8) eight children supervised by Licensee and her Assistant. It was alleged that facility staff hit children, threaten children, and do not allow children to have water. A facility inspection was conducted , pertinent information to assist with the investigation was reviewed and interviews were conducted with the reporting party, Licensee, facility staff and parents of children in care. Licensee denied all allegations. Information obtained revealed that children are able to access water through their water bottles. In addition, the Licensee ensures water is available at all times. Inconsistent statements were received regarding disciplining of children in care. Based on the information received, the allegations are determined to be unsubstantiated. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
An exit interview was conducted and a Notice of Site Visit and appeal rights were provided to the Licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Stacey Williams
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2022
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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