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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 233009332
Report Date: 12/03/2020
Date Signed: 12/03/2020 03:53:52 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/21/2020 and conducted by Evaluator Mary Trinh
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20200721085435
FACILITY NAME:HENDRICKS, KRISTINE FCCHFACILITY NUMBER:
233009332
ADMINISTRATOR:HENDRICKS, KRISTINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 962-3003
CITY:FORT BRAGGSTATE: CAZIP CODE:
95437
CAPACITY:14CENSUS: 4DATE:
12/03/2020
ANNOUNCEDTIME BEGAN:
02:29 PM
MET WITH:Kristine Hendricks, LicenseeTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Licensee not meeting the 80% requirements to be in daycare.
INVESTIGATION FINDINGS:
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Due to COVID-19 an announced tele-visit using FaceTime was conducted by Licensing Program Analyst, (LPA) Mary Trinh with Kristine Hendricks, Staff 1 (S1) to deliver complaint finding. It has been alleged that Licensee not meeting the 80% requirements to be in daycare specifically that Licensee is only at her day care home during drop off and pick up times.
On 07/23/2020 at 2:10 pm, LPA Trinh interviewed Licensee (S1) who denied the allegation, stating that she only leaves her day care home to attend necessary appointments. On 07/23/2020 at 2:20 pm, LPA Trinh interviewed S2 who denied the allegation stating that S1 only leaves her day care home to attend to necessary appointments. On 07/23/2020 a tour of the day care home was given by S1 and LPA Trinh observed 4 pre- school aged children in the home. There were two staff present.
LPA Trinh interviewed Parents on the dates and times of 11/18/2020 at
5:00 pm, and 5:45 pm; and 11/19/2020 at 1:00 pm. Parents confirmed that they cannot give a percentage of when S1 was not at her day care home. Also, parents stated that S1 will let them know when she has to step out of her day care home to attend to appointments or do errands.
Continued...

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary TrinhTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020
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 2
Control Number 01-CC-20200721085435
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928
FACILITY NAME: HENDRICKS, KRISTINE FCCH
FACILITY NUMBER: 233009332
VISIT DATE: 12/03/2020
NARRATIVE
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This agency has investigated the complaint alleging that Licensee not meeting the 80% requirements to be in day care. We have found that the complaint was Unsubstantiated.
Based on the information gathered during this investigation, there is insufficient information to prove or disprove the allegations as reported. There is not a preponderance of the evidence to prove the allegations, therefore the findings are determined to be Unsubstantiated.
Advisory on Operation of a Family Child Care Home (102417)(a) was explained to S1. This report was reviewed and discussed with S1. This report and regulation Operation of a Family Child Care Home (102417)(a) will be emailed and mailed to facility.
SUPERVISOR'S NAME: Alexis HollonTELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary TrinhTELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 2