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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 394500342
Report Date: 07/23/2024
Date Signed: 07/23/2024 10:35:23 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 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
07/05/2024 and conducted by Evaluator David Nguyen
PUBLIC
COMPLAINT CONTROL NUMBER: 53-CC-20240705115913
FACILITY NAME:EVELYN, PATRICIAFACILITY NUMBER:
394500342
ADMINISTRATOR:EVELYN, PATRICIAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 487-2610
CITY:STOCKTONSTATE: CAZIP CODE:
95219
CAPACITY:14CENSUS: 8DATE:
07/23/2024
UNANNOUNCEDTIME BEGAN:
09:40 AM
MET WITH:Evelyn, PatriciaTIME COMPLETED:
10:45 AM
ALLEGATION(S):
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Children engaged in inappropriate behavior due to lack of supervision.
INVESTIGATION FINDINGS:
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On July 23rd, 2024, at 9:30 AM, Licensing Program Analyst (LPA) David Nguyen and Licensing Program Manager (LPM) Chayntel Hunter conducted a complaint investigation visit and met with Licensee, Patricia Evelyn. The purpose of the inspection visit was to deliver the findings for the above allegation. LPA disclosed the purpose of the inspection and were granted entrance. LPA toured the facility inside and outside and observed eight (8) children being supervised by Licensee.

During the course of the investigation, LPA conducted interviews with Licensee, Reporting Party, and Victim Child (C1). In addition, LPA obtained information pertaining to the allegation and observed the care and supervision of the daycare children. It was alleged that “Children engaged in inappropriate behavior due to lack of supervision.”
Report continues on LIC9099-C....(Page 2)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
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-20240705115913
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: EVELYN, PATRICIA
FACILITY NUMBER: 394500342
VISIT DATE: 07/23/2024
NARRATIVE
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(Page 2)
Based on interviews with Licensee, Reporting Party, and Victim Child (C1), LPA obtained corroborating information from licensee, reporting party, and victim child. Interview revealed that licensee and assistant were not present in the room with children while the children napped at her FCCH daycare facility. C1 was touched inappropriately by another child (C2) while they were in the room during nap time. In addition, interviews conducted revealed that there was at least one (1) occasion where the Licensee, Patricia Evelyn did not provide adequate supervision to children while they were in her care.

Based on records reviewed and interviews conducted it was determined that the preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. The following Title 22 Deficiency is being cited on the subsequent 9099-D page.

Appeal Rights and Notice of Site Visit were provided. Notice of Site Visit must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee. A notice of site visit was provided and must remain posted for 30 days. Licensee's signature on this form acknowledges receipt of this form. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Nguyen informed licensee, Patricia Evelyn that this report dated July 23rd, 2024, documents one (1) Type A citation during the course of investigation.

Also, LPA Nguyen informed the Licensee to provide a copy of this licensing report dated July 23rd, 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: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 53-CC-20240705115913
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: EVELYN, PATRICIA
FACILITY NUMBER: 394500342
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/24/2024
Section Cited
CCR
102417(a)
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102417 Operation of a Family Child Care Home (a) The licensee shall be present in the home and shall ensure that children in care are supervised at all times….This requirement was not met as evidenced by:
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Licensee agrees to complete the “Supervision” training session on the CCLD website. In addition, the licensee agrees to closely supervise daycare children while they are in her care.
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Based on records reviewed and interviews conducted, it was revealed that C1 was inappropriately touched by C2. This poses an immediate health, safety, or personal rights risk to 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: Chayntel Hunter
LICENSING EVALUATOR NAME: David Nguyen
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2024
LIC9099 (FAS) - (06/04)
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