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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 573614773
Report Date: 04/23/2024
Date Signed: 04/23/2024 12:05:53 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 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
04/16/2024 and conducted by Evaluator Lauren Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240416155155
FACILITY NAME:PINCILOTTI, LILYFACILITY NUMBER:
573614773
ADMINISTRATOR:PINCILOTTI, LILYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 220-3499
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY:14CENSUS: 7DATE:
04/23/2024
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:licensee, Lily PincilottiTIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee does not ensure outdoor play areas are free from hazards.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) Lauren Scott and Janie Davis met with licensee, Lily Pincilotti to conduct a complaint investigation regarding the above allegation.
During the course of the investigation, LPA Scott conducted interviews, and obtained information pertaining to allegation. It was alleged that licensee's outdoor space was not free from hazards. LPA observed a section of the fence to be leaning and unstable. LPA discussed leaving the backyard off limits until the area is repaired.
Based on the interviews and observations, it was revealed that the backyard fence was needing repairs to prevent access to potential hazards, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
An exit interview was conducted with the licensee. 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.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2024
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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