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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 574500485
Report Date: 10/10/2024
Date Signed: 10/10/2024 03:12:49 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
10/03/2024 and conducted by Evaluator Lauren Scott
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20241003164735
FACILITY NAME:YCOE MARGUERITE MONTGOMERYFACILITY NUMBER:
574500485
ADMINISTRATOR:GENET TELAHUN/SILVIA MEZAFACILITY TYPE:
850
ADDRESS:1441 DANBURY STREETTELEPHONE:
(530) 668-3010
CITY:DAVISSTATE: CAZIP CODE:
95618
CAPACITY:48CENSUS: 19DATE:
10/10/2024
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Katrina HopkinsTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Staff left daycare child unattended.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Lauren Scott met with facility representative, Katrina Hopkins to deliver the findings of the 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 a daycare child was unattended.

Based on the interviews, it was revealed one child got out of the play yard and ran into the other classroom. During this time, the child was left without sueprvision for a period of time between leaving the play yard and reaching the classroom. Therefore, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. Title 22 regulations are being cited on the attached 9099-D page.
Report continues on 9099-C.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
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 3
Control Number 53-CC-20241003164735
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: YCOE MARGUERITE MONTGOMERY
FACILITY NUMBER: 574500485
VISIT DATE: 10/10/2024
NARRATIVE
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An exit interview was conducted with the Director. 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.

LPA Scott informed facility representative, Katrina Hopkins, that this report dated 10/10/2024, documents one Type A citations which shall be posted for 30 consecutive days as there is and immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Scott informed the facility representative to provide a copy of this licensing report dated 10/10/2024, that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20241003164735
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO SOUTH, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: YCOE MARGUERITE MONTGOMERY
FACILITY NUMBER: 574500485
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/10/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/11/2024
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision... (1) No child(ren) shall be left without the supervision of a teacher at any time...Supervision shall include visual observation. This requirement was not met as evidenced by:
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facility will install new child proof lock on play yard gate, and/or submit plan. Faciltiy will conduct a staff meeting discussing maintaining 100% supervision at all time.

THIS IS A REPEAT VIOLATION FROM 3/25/24- LACK OF SUPERVISION
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Based on interviews, the facility did not comply with the section cited above which poses an immediate health, safety or personal rights risk to persons in care.
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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: Chayntel Hunter
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3