573621481-5-9-2022-53-CC-BENN-CEBLS7-20220511090013

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 573621481
Report Date: 05/09/2022
Date Signed: 05/09/2022 01:55:13 PM

Unsubstantiated

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
04/12/2022 and conducted by Evaluator Lauren Scott

PUBLIC

COMPLAINT CONTROL NUMBER: 53-CC-20220412163538

FACILITY NAME:	HODGE, TIFFANY		FACILITY NUMBER:	573621481
ADMINISTRATOR:	HODGE, TIFFANY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(618) 663-0574
CITY:	WOODLAND	STATE: CA	ZIP CODE:	95776
CAPACITY:	14	CENSUS: 12	DATE:	05/09/2022
		UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Licensee, Tiffany Hodge		TIME COMPLETED:	02:10 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee is operating beyond the terms and conditions of the license

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Chayntel Hunter and Lauren Scott met with Licensee, Tiffany Hodge to deliver the findings of the complaint investigation regarding the above allegation. During the course of the investigation, LPA Hunter conducted interviews, and obtained information pertaining to allegation. It was alleged that the Licensee was operating out of ratio. Interviews conducted did not corroborate the allegation, and LPA was unable to determine if the facility was operating out of ratio. Although the Licensee allows visitors, staff to child ratios are maintained according to Title 22 regulations.

Based on the information obtained throughout the course of this investigation the above allegations could not be substantiated or dismissed. 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 finding is UNSUBSTANTIATED. Exit interview was conducted. A notice of site visit was provided and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Lauren Scott
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2022

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 1