394500355-7-7-2023-53-CC-BENN-CTMUWV-20230711155718

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 394500355
Report Date: 07/07/2023
Date Signed: 07/07/2023 10:34:00 AM

Unsubstantiated

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
04/14/2023 and conducted by Evaluator Elvira Sierra

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20230414150739

FACILITY NAME:	CAMPUS II, INC, THE		FACILITY NUMBER:	394500355
ADMINISTRATOR:	MEGHAN GODDARD		FACILITY TYPE:	850
ADDRESS:	6311 PACIFIC AVE.		TELEPHONE:	(209) 951-5437
CITY:	STOCKTON	STATE: CA	ZIP CODE:	95207
CAPACITY:	30	CENSUS: 14	DATE:	07/07/2023
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Tyanne Woodyard-Smith		TIME COMPLETED:	10:45 AM

ALLEGATION(S):

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Neglect/Lack of Supervision-Child sustaining injury due to lack of supervision

INVESTIGATION FINDINGS:

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On 07/07/23, Licensing Program Analyst (LPA) Elvira Sierra met with Assistant Director, Tyanne Woodyard-Smith to deliver complaint finding for the above allegation. During today's inspection there were Assistant Director and two staff supervising 14 daycare children.
It was alleged child #1 sustaining injury due to lack of supervision. Throughout the course of investigation LPA Sierra conducted interviews with the reporting party (RP), staff, and parents. LPA also conducted observations and reviewed pertaining documents. Staff stated that all incidents are reported to parent or authorized representative via Procare and in person if necessary. Staff stated that facility call parents just to let them know about the incident, explain what happened and how it was handled. Parents that were interviewed did not disclose having any concerns regarding supervision and stated that they always get informed of any incidents immediately. Assistant Director stated that occasionally when she is in helping in the classroom, she keeps one earpiece in her ear to be able to answer calls if necessary. She also stated that most of the time she is not in ratio only assisting in the classroom if needed. LPA review child # 1 file and did not find any incident pertaining to a head injury in the alleged month that the incident occurred. Report continues on subsuquent page 809C--

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

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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Control Number 53-CC-20230414150739

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: CAMPUS II, INC, THE	FACILITY NUMBER: 394500355
	VISIT DATE: 07/07/2023

NARRATIVE

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Due to conflicting information gathered throughout the course of this investigation the above allegation could not be substantiated or dismissed. Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the finding are UNSUBSTANTIATED.

Appeal of Rights and this report were provided and reviewed with Assistant Director,Tyanne Woodyard Smith. Exit interview was conducted. Notice of Site Visit was posted and should remain posted for 30 days.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:	DATE: 07/07/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/07/2023

LIC9099 (FAS) - (06/04)

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