Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 393620268
Report Date: 04/03/2017
Date Signed 07/07/2017 03:04:46 PM


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
03/06/2017 and conducted by Evaluator Katina Boulai
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20170306100003
FACILITY NAME:JURAN, MELANIEFACILITY NUMBER:
393620268
ADMINISTRATOR:JURAN, MELANIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 407-6068
CITY:TRACYSTATE: CAZIP CODE:
95377
CAPACITY:14CENSUS: 8DATE:
04/03/2017
UNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Melanie JuranTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Licensee is failing to supervise children in care
INVESTIGATION FINDINGS:
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This is an amended report delieved by LPA Mary Ponce and LPM Monica Filice on 7/7/17. Licensing Program Analyst Katina Boulai met with Licensee Melanie Juran in order to close the complaint investigation stating that Licensee is failing to supervise children in care. During today's visit LPA toured the facility and interviewed licensee. LPA previously interviewed parents and gymnastic teacher during the investigation process.

Based on the investigation conducted, LPA learned that the provider and her husband do not provide adequate supervision at the park. It was reported that children are left unattended in swings, strollers, and licensee has been observed on her phone not supervising the children. LPA discovered during the investigation process that there was a child that left the facility last year in July. The child walked to the right of the house, one house over. Licensee did not report the incident to licensing as required by law. Based on LPA's investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California code of regulations, (Title 22 , Division & Chapter number), are being cited on the attached LIC. 9099D.

Upon receipt of Type A citations, licensee shall post and provide copies of the LIC 809 D for parents/guardians of children in care and for parents/guardians of newly enrolled children for the next 12 months. Director must also keep the signed LIC 9224, acknowledging receipt of LIC 809 D in each child's file.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Monica R FiliceTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mary PonceTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2017
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 03-CC-20170306100003

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
FACILITY NAME: JURAN, MELANIE
FACILITY NUMBER: 393620268
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2017
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/04/2017
Section Cited
102352 (f) (1)
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"Family Day Care" or "Family Child Care" means regularly provided care, protection and supervision of children, in the care giver's own home, for periods of less than 24 hours per day, while the parents or authorized representatives are away.
Licensee was not supervising a child who walked out of her facility.
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Licensee will install a window and door alarm and will send a picture to LPA by 4/3/17.
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Licensee and husband were observed not providing adequate supervision at the park. In a serparate event, a child left the facility in July 2016 and walked a house over to the right of licensee's home. Licensee did not inform licensing per regulations.

Licensee promised the parents of the child to install an alarm which was not installed.
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Type B
04/04/2017
Section Cited
102416.2 b
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Reporting Requirements. The licensee shall report to the Department any of the events as specified in Health and Safety Code Section 1597.467(b)(1)(A)
through (b)(1)(C) that occur during the operation of the family child care home. A child walked out of the facility and licensee did not report the incident to licensing.
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Licensee will report all incidents to licensing as required in the health and safety code. LPA Boulai discussed examples of what should be reported. LPA advised that licensee call the Officer of the day and ask if she is not sure if an incident should be reported.
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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.
SUPERVISOR'S NAME: Monica R FiliceTELEPHONE: (916) 263-5715
LICENSING EVALUATOR NAME: Mary PonceTELEPHONE: (916) 263-5744
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2017
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2017
LIC9099 (FAS) - (06/04)
Page: 2 of 2