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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343623207
Report Date: 09/27/2021
Date Signed: 09/27/2021 11:13:00 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
09/09/2021 and conducted by Evaluator Amanda Blesi
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20210909163245
FACILITY NAME:NOLAND, NICOLETTEFACILITY NUMBER:
343623207
ADMINISTRATOR:NOLAND, NICOLETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(714) 292-8000
CITY:SACRAMENTOSTATE: CAZIP CODE:
95816
CAPACITY:14CENSUS: 4DATE:
09/27/2021
UNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Nicolette NolandTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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Licensee is not present at the facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst Amanda Blesi met with licensee Nicolette Noland today to close the complaint. Present today were 4 day care children, licensee, and two assistants. During the investigation, interviews were conducted and observations were made at the facility. Licensee states she has been on a maternity leave since early August of this year. For the last few months she has been staying with her in laws while she has had her two assistants operating her day care in her absence and she would stop by periodically to check on things. Based on licensee's own statements and of those interviewed, the preponderance of evidence standard has been met and the allegation is SUBSTANTIATED.

Title 22 Deficiencies are cited on the following page LIC 9099-D.
Exit interview with Nicolette Noland
Appeal rights provided.
Notice of Site visit posted upon exit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021
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 03-CC-20210909163245
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: NOLAND, NICOLETTE
FACILITY NUMBER: 343623207
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/27/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/27/2021
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 of the hours that the facility is providing care per day.
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Licensee states she was under the impression she could take a maternity leave of absence while still maintaining a license. She states she understands she must live in the home and be present 80% of the time. She plans to add her mother in law to her license so she can have extra help with the baby. To correct the deficiency, licensee shall submit a signed written statement with a plan showing how she will be present 80% of the time. In additon, LPA will make a return visit to ensure licensee is present in the day care.
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This requirement was not met as evidenced by: licensee admitted she has not been present in the facility 80% of the time because she has been on maternity leave since beginning of August. She states she has been staying with her in laws while her assistants were managing her day care in her absence. She would check in at least once a week to see how things were going. This is a potential risk to the health and safety of children 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: Keven Peters
LICENSING EVALUATOR NAME: Amanda Blesi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3