Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455406533
Report Date: 09/19/2018
Date Signed 09/19/2018 11:35:50 AM


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/11/2018 and conducted by Evaluator Patricia Pacheco
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20180711144957
FACILITY NAME:LACK, KIMBERLY FAMILY CHILD CARE HOMEFACILITY NUMBER:
455406533
ADMINISTRATOR:LACK, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 510-1928
CITY:REDDINGSTATE: CAZIP CODE:
96001
CAPACITY:14CENSUS: 8DATE:
09/19/2018
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Kimberly LackTIME COMPLETED:
11:40 AM
ALLEGATION(S):
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Adult in home bit a child in care.
Licensee is not present at least 80% of the time.
INVESTIGATION FINDINGS:
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A subsequent complaint investigation inspection was conducted at the facility Licensing Program Analyst (LPA) Patricia Pacheco. The complaint was originally opened on 07/12/18, by LPA Jaime Snow. It has been alleged that an adult in the home bit a child in care; specifically, that the licensee bit a child as a form of discipline. The licensee continued to deny the allegation and stated that she has and would never bite any child. During the investigation inspections on 07/12/18 and 09/19/18, LPAs observed the licensee and her assistant to be appropriately interacting with children in care. Child, staff and witness interviews were conducted. It was corroborated that the licensee has not been observed to bite any children and that redirection and timeouts are the only form of discipline used at the facility. Based on available information, although the allegation 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 allegation is unsubstantiated.

It has been alleged that the licensee is not present at the facility at least 80% of the time that child care is being provided. The licensee continued to deny the allegation and stated that she does run a few
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2018
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 2
Control Number 13-CC-20180711144957
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: LACK, KIMBERLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406533
VISIT DATE: 09/19/2018
NARRATIVE
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errands during the week or works in the main home at times, but is not gone from the facility more than 80% of the time. The licensee stated that the only other time that she is away from the facility is during planned vacations. The licensee stated that if she is away from the facility, she ensures that her assistants have the required clearances and certifications in place. During the investigation inspections, LPAs observed that the licensee was on the facility grounds and providing appropriate care to the children present. Child, staff and witness interviews were conducted. It was corroborated that the licensee has not been observed to be away from the facility for more than 80% of the time that children are in care. Based on available information, although the allegation 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 allegation is unsubstantiated.

This report was reviewed with the licensee. Appeal rights were provided. Notice of site visit must be posted for 30 days from today’s inspection.

SUPERVISOR'S NAME: Erin VirruetaTELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: Patricia PachecoTELEPHONE: 530-895-5886
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2018
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2018
LIC9099 (FAS) - (06/04)
Page: 2 of 2