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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343618096
Report Date: 03/16/2022
Date Signed: 03/29/2022 08:57:58 AM

Substantiated


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
01/13/2022 and conducted by Evaluator Alize Tillery
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220113162515
FACILITY NAME:LYON, LAURAFACILITY NUMBER:
343618096
ADMINISTRATOR:LYON, LAURAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(916) 517-0680
CITY:SACRAMENTOSTATE: CAZIP CODE:
95841
CAPACITY:14CENSUS: 0DATE:
03/16/2022
ANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Laura LyonTIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Licensee does not live in the home
INVESTIGATION FINDINGS:
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On March 16, 2022, at approximately 1:30 PM, Licensing Program Analysts (LPAs) Alize Tillery and Josiah Gathing and Licensing Program Manager (LPM) Seychelle De Luca, met with the Licensee, Laura Lyon, virtually via Zoom, for the purpose of delivering the findings to the above allegation. The meeting is taking place via Zoom due to the Licensee not being in Sacramento.

During the course of the investigation, LPAs conducted interviews with the licensee and parents. It was alleged that Licensee does not live in the home. On 2/9/2022, Licensee informed LPA Tillery that she was not in Sacramento and does not plan on returning until possibly September 2022. During parent interviews, parents also confirmed Licensee does not live in the home where care is provided. During today's meeting, Licensee confirmed that she recently moved to a different area due to personal reasons.
Based on information obtained from interviews, record review and LPAs observations, the preponderance of evidence standard has been met; therefore the allegation is found to be SUBSTANTIATED. A type A deficiency is being issued. See 809D for deficiency cited.

Report continues...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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 4
Control Number 03-CC-20220113162515
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: LYON, LAURA
FACILITY NUMBER: 343618096
VISIT DATE: 03/16/2022
NARRATIVE
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Licensee has decided to terminate her license effective today, 3/16/2022.

LPAs reviewed the report with Licensee. A copy of the report and appeal rights will be emailed to Licensee.
Acknowledgement of delivery will constitute acknowledgement of the report in lieu of a signature.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
01/13/2022 and conducted by Evaluator Alize Tillery
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220113162515

FACILITY NAME:LYON, LAURAFACILITY NUMBER:
343618096
ADMINISTRATOR:LYON, LAURAFACILITY TYPE:
810
ADDRESS:4945 TYLER STREETTELEPHONE:
(916) 517-0680
CITY:SACRAMENTOSTATE: CAZIP CODE:
95841
CAPACITY:14CENSUS: 0DATE:
03/16/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Laura LyonTIME COMPLETED:
01:40 PM
ALLEGATION(S):
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Animal feces are accessible to children
Facility does not have comfortable temperature
Unfingerprinted adults lived in the home
INVESTIGATION FINDINGS:
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On March 16, 2022, at approximately 1:30 PM, Licensing Program Analysts (LPAs) Alize Tillery and Josiah Gathing and Licensing Program Manager (LPM) Seychelle De Luca, met with the Licensee, Laura Lyon, virtually via Zoom, for the purpose of delivering the findings to the above allegations. The meeting is taking place via Zoom due to the Licensee not being in Sacramento.
It was alleged that the facility has animal feces accessible to children, that the facility does not maintain comfortable temperature, and that unfingerprinted adults reside in the home. During the course of the investigation, LPAs received contradicting information and did not observe animal feces nor did the facility appear to have uncomfortable temperatures. At this time, all adults residing in the home have been live scan fingerprinted.
Based on the investigation conducted, although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violations occurred. As a result, the allegations are UNSUBSTANTIATED.
Licensee has decided to terminate her license effective today, 3/16/2022.
LPAs reviewed the report with Licensee. A copy of the report and appeal rights will be emailed to Licensee.
Acknowledgement of delivery will constitute acknowledgement of the report in lieu of a signature.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
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 4
Control Number 03-CC-20220113162515
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: LYON, LAURA
FACILITY NUMBER: 343618096
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/16/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/17/2022
Section Cited
CCR
102417(a)
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The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent...
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Licensee decided to terminate her license effective 3/16/2022. Licensee stated she will consider reapplying when/if she returns to Sacramento.
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...of the hours that the facility is providing care per day.
This requirement was not met, evidenced by: Licensee confirmed that she has moved out of the licensed residence, and is no longer living in Sacramento.
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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: Seychelle De Luca
LICENSING EVALUATOR NAME: Alize Tillery
LICENSING EVALUATOR SIGNATURE:

DATE: 03/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/16/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4