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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 394500724
Report Date: 02/12/2024
Date Signed: 02/13/2024 05:21:16 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
11/21/2023 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20231121170229
FACILITY NAME:LEVINGSTON, JA'NAYFACILITY NUMBER:
394500724
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 4DATE:
02/12/2024
UNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Ja'nay LevingstonTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Ratio-Provider is operating over capacity.
Crminal Record Clearance-Provider leaves day care children unsupervised with uncleared adults.
INVESTIGATION FINDINGS:
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This is an amended version of a report originally signed on 02/12/24.
On February 12, 2024, Licensing Program Analyst (LPA) Elvira Sierra met with Licensee, Ja’nay Levingston to conduct additional interviews for a complaint investigation and deliver findings. Upon arrival LPA observed 3 children being supervised by Licensee and her assistant. One more child arrived later during the inspection.
It was alleged that Provider is operating over capacity and leaves day care children unsupervised with uncleared adults. LPA conducted interviews with the Licensee, daycare parents, children, and reviewed records. The Licensee admitted during an interview conducted on inspection dated 11/29/23 that, on occasions, parents are late, or children are unexpectedly dropped off, making her over-capacity. The licensee stated that Adult # 1visits the facility occasionally and had interact with the daycare children. The licensee stated that she was not aware that Adult # 1 needed to have fingerprint clearance to interact with the children and explained that Adult # 1 has never been left alone with the children. LPA discussed the license capacity and provided small FCCH capacity options information.
Report continues subsequent page 809C--
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
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 5
Control Number 53-CC-20231121170229
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: LEVINGSTON, JA'NAY
FACILITY NUMBER: 394500724
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/13/2024
Section Cited
CCR
102416.5(a)
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This is an amended version of a report originally signed on 02/12/24.
102416.5 Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time. This requirement was not met as evidence by; Licensee admitted that on occasions she has been over her License capacity having more than 8 children present at one time. This is a violation that if not corrected poses an immediate risk to the children in care.

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POC: Licensee stated that she will talk to parents regarding picking up their children on time. Licensee stated that she is in the process to increase her capacity to large FCCH to avoid future incidents. LPA received Licensee application for large FCCH on 12/13/23.
Type A
02/13/2024
Section Cited
CCR
102370(d)
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102370 Criminal Record Clearance
(d) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing, or volunteering in a licensed facility: This requirement was not met as evidence by; Interviews and records review revealed that Adult # 1 has no fingerprint clearance on file with Licensing office and is present at the home occasionally interacting with the daycare children. This is a violation that if not corrected poses an immediate risk to the children in care.
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POC; Licensee stated that she will submit Adult #1 fingerprints before adult #1 can be present in the facility. Licensee stated that Adult # 1 won't have any interaction with the children unless she is fingerprint clear and have all assistant provider requirements.
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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: 02/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
11/21/2023 and conducted by Evaluator Elvira Sierra
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20231121170229

FACILITY NAME:LEVINGSTON, JA'NAYFACILITY NUMBER:
394500724
ADMINISTRATOR:LEVINSGTON, JA'NAYFACILITY TYPE:
810
ADDRESS:437 PICKWOOD LNTELEPHONE:
(209) 696-1298
CITY:STOCKTONSTATE: CAZIP CODE:
95207
CAPACITY:10CENSUS: DATE:
02/12/2024
UNANNOUNCEDTIME BEGAN:
01:55 PM
MET WITH:Ja'nay LevingstonTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Personal Rights-Provider allows minor in home to care and supervise day care children.
Personal Rights-Provider does not properly transport day care children in vehicle.
INVESTIGATION FINDINGS:
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This is an amended version of a report originally signed on 02/12/24.
On February 12,2024, Licensing Program Analyst (LPA) Elvira Sierra met Ja’nay Levingston to conduct addition interviews for a complaint investigation and deliver findings. Upon arrival LPA observed three children being supervised by Licensee and assistant. One more child arrived later during the inspection.
It was alleged that provider allows minor in home to care and supervise day care children and that provider does not properly transport daycare children in vehicle. During the investigation LPA conducted interviews with staff, daycare parents and children. LPA observed the care and supervision of the children, reviewed records and collected additional documentation. LPA learned during interviews that provider has an assistant that helps with the children whenever is needed. LPA reviewed assistant’s file. Assistant provider on record has criminal record clearance on file with Licensing office. LPA observed proof of CPR certification as well as required documents needed to be an assistant provider. LPA conducted observations at the facility on inspections date 11/21/23 and 02/12/24. LPA observed that provider has several booster seats and car seats that are used for daycare children when providing transportation.
Report continues on subsuquent page 809C--
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 53-CC-20231121170229
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: LEVINGSTON, JA'NAY
FACILITY NUMBER: 394500724
VISIT DATE: 02/12/2024
NARRATIVE
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Provider denies the allegation regarding not properly transporting children and stated that she uses appropriate restrains such as car seats or booster seats while transporting children. Provider stated that her minor daughter interacts with the daycare children, but she is never alone with the children. None of the parents that were interviewed disclosed any concerns regarding the care, supervision, or transportation of children. Interviews did not reveal that a minor care for the children.

Based upon interviews conducted, records review and observations while at the facility, there is not a preponderance of evidence to prove or disprove the allegations did or did not occur, therefore the above allegations are found to be UNSUBSTANTIATED. Exit interview was conducted with Licensee, Ja'nay Levingston and appeal of rights were provided. Notice of site visit is posted for 30 days.

SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20231121170229
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: LEVINGSTON, JA'NAY
FACILITY NUMBER: 394500724
VISIT DATE: 02/12/2024
NARRATIVE
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LPA also provided LIC 9163 Request for Live Scan form to Licensee. Licensee stated that she is in the process of increasing her license capacity to a large family childcare to avoid facility to be over capacity. Based on interviews the preponderance of evidence standard has been met, therefore the above allegations is found to be SUBSTANTIATED.

Type A deficiencies were cited during the visit on the attached LIC 9099 D. Upon receipt of Type A citation, licensee shall post and provide copies of the LIC 9099D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Licensee must also keep the signed LIC 9224, acknowledging receipt of LIC 9099D in each child's file.
Exit interview conducted. Appeal of Rights and this report were reviewed and provided to Licensee, Ja'nay Levingston. Notice of Site Visit posted.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Elvira Sierra
LICENSING EVALUATOR SIGNATURE:

DATE: 02/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/12/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5