115401538-2-2-2021-13-CC-EVIA-BY3MUG-20210209085503

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 115401538
Report Date: 02/02/2021
Date Signed: 02/02/2021 03:30:57 PM

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
05/29/2020 and conducted by Evaluator David Wilson

PUBLIC

COMPLAINT CONTROL NUMBER: 13-CC-20200529113420

FACILITY NAME:	WOODS, JOAN FAMILY CHILD CARE HOME		FACILITY NUMBER:	115401538
ADMINISTRATOR:	WOODS, JOAN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(530) 865-3512
CITY:	ORLAND	STATE: CA	ZIP CODE:	95963
CAPACITY:	14	CENSUS: 11	DATE:	02/02/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Joan Woods		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Uncleared adult residing in the home

INVESTIGATION FINDINGS:

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On 02/02/21 Licensing Program Analyst (LPA) David Wilson conducted this follow-up complaint inspection meeting with Joan Woods (licensee) to discuss this report via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak.
It was alleged an uncleared adult (A1) residing in this facility. Regarding the allegations, during LPA interview on 06/04/2020 licensee stated A1 is family member and visiting guest temporarily staying part of any given week in a trailer that is not located at facility and also staying as a guest at this facility. Licensee stated A1 being in process of finding a permanent residence. Licensee explained that whenever A1 is a guest at the facility, A1 does not provide child care. Licensee stated A1 has some personal belongings stored at both the above locations. During LPA's 06/04/2020 inspection LPA interviewed an adult (A2) associated to facility who corroborated that A1 does not reside at facility and only stays as a guest since A1 is a family member and that A1 does not provide child care at facility. On 06/10/20 LPA interviewed four client parents of this facility. During parent interviews there was no preponderance of evidence to the allegation. Continued on next page...

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 13-CC-20200529113420

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: WOODS, JOAN FAMILY CHILD CARE HOME	FACILITY NUMBER: 115401538
	VISIT DATE: 02/02/2021

NARRATIVE

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LPA reviewed Caregiver Background Check Bureau clearance information that shows A1 is cleared and associated to facility as of 06/26/2020.

Based on the evidence LPA obtained per above although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and so the findings are unsubstantiated.

The Notice of Site Visit must be posted for 30 days.

SUPERVISOR'S NAME: Erin Virrueta	TELEPHONE: (530) 895-4325
LICENSING EVALUATOR NAME: David Wilson	TELEPHONE: (530) 513-0993
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021

LIC9099 (FAS) - (06/04)

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