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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455406696
Report Date: 05/19/2023
Date Signed: 05/19/2023 12:16:02 PM

Substantiated


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
01/19/2023 and conducted by Evaluator Bianca Mendez
COMPLAINT CONTROL NUMBER: 13-CC-20230119100934
FACILITY NAME:MARRIOTT, MOLLY FAMILY CHILD CARE HOMEFACILITY NUMBER:
455406696
ADMINISTRATOR:MARRIOTT, MOLLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 227-1851
CITY:COTTONWOODSTATE: CAZIP CODE:
96022
CAPACITY:14CENSUS: DATE:
05/19/2023
UNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Molly MarriottTIME COMPLETED:
12:20 PM
ALLEGATION(S):
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Daycare child sustained unexplained fracture while in care.
Licensee did not report a day care child’s injury requiring medical treatment to Licensing.
INVESTIGATION FINDINGS:
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On 5/19/23 at 11:55am Licensing Program Analyst (LPA), Bianca Mendez and Licensing Program Manager (LPM) Megan Aviles conducted an unannounced inspection to deliver findings for the allegations listed above. LPA met with licensee, Molly Marriott, and discussed the purpose of the inspection. This complaint investigation was conducted by Community Care Licensing Division Investigative Branch (IB) Investigator, Christen Krogstad. During the course of the investigation, interviews were conducted with the licensee and parents of children in care. Records from outside agencies were obtained and reviewed.


Continued on 9099C

Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
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 5
Control Number 13-CC-20230119100934
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: MARRIOTT, MOLLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406696
VISIT DATE: 05/19/2023
NARRATIVE
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It was alleged that a child (C1) sustained an unexplained fracture, specially that the C1 sustained a broken right femur while in care. During Interviews conducted with the licensee and inconsistent statements were made as to how C1 received the injury. The licensee later admitted that C1, along with other children in care had been jumping on a child safety gate and “rough housing” for about 1-2 minutes before C1 was injured but the licensee did not see the incident occur. The licensee admitted to telling the children to stop climbing on a gate but failed to physically intervene. Evidence collected during the investigation confirmed that a child safety gate that led to the licensee’s outdoor play area was installed incorrectly leaving an approximate 6 inch gap from the door’s threshold to a step leading out the door to the backyard. The licensee admitted to the door being open at the time of the incident occurred.

Interviews with parents confirmed on the day the injury occurred, there was a large play structure in the in the daycare room. The play structure was described as a two-story loft or bunkbed. This structure was not present in the daycare room at the time Investigator Krogstad visited the facility. The licensee made no mention of this structure during interviews with Investigator Krogstad.

It was also alleged that the licensee failed to report the injury involving C1, which required medical treatment, to the Department as required. The licensee admitted to not reporting the incident to the Department within 24 hours as required stating she was unaware that a written report/notification was required. The incident involving C1 occurred on 1/02/2023, the licensee reported the incident by telephone to the Department on 1/19/23.

Based on interviews conducted and records reviewed, the preponderance of evidence standard has been met, therefore the above allegations are found to be substantiated. California Code of Regulations, (Title 22, Division 12) are being cited on attached LIC 9099D.


Continued on 9099C
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 13-CC-20230119100934
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: MARRIOTT, MOLLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406696
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/01/2023
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home. The licensee shall be present in the home and shall ensure that children in care are supervised at all times.

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Informal meeting wiill be scheduled if licensee chooses to resume child care.
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This requirement was not met as evidence by: Interview with the licensee. Licensee failed to properly supervise children in care and admitted to not witnessing the incident with C1 and could not explain how the incident occurred.

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Type A
05/01/2023
Section Cited
CCR
102423(a)(2)
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Personal Rights. Each child shall be accorded safe, healthful and comfortable accommodations, furnishing and equipment.

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Informal meeting wiill be scheduled if licensee chooses to resume child care.
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This requirement was not met as evidence by observation, interview, and record review. The licensee failed to provide safe accommodations and equipment to children in care by improperly installing a baby gate and by allowing children in care to have access to a large two story bunk-bed like structure.

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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.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 13-CC-20230119100934
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: MARRIOTT, MOLLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406696
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/19/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/01/2023
Section Cited
CCR
102416.2
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(b) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family child care home.

(1) Medical treatment means treatment by a medical professional, as defined in Section 101152(m).
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Informal meeting wiill be scheduled if licensee chooses to resume child care.
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This requirement was not met as evidence by interview and record review. The licensee failed to report the injury involving C1 which required medical treatment to the Department as required.

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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.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 13-CC-20230119100934
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: MARRIOTT, MOLLY FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406696
VISIT DATE: 05/19/2023
NARRATIVE
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LPA, Bianca Mendez informed the licensee that this report dated 5/19/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety or personal rights of children in care.

LPA, Bianca Mendez also informed the licensee to provide a copy of this licensing report dated 5/19/23 that documents a Type A citation to parents and guardians of all children enrolled by the next business day or the next day children are in care, and to any newly enrolled parents/guardians for the next 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.

The Department has determined that a Civil Penalty will be issued for the substantiated allegation of daycare child sustained unexplained fracture C1 received while under the care of the licensee. LPA Bianca Mendez reviewed the Civil Penalty Assessment – Serious Bodily Injury (LIC421D) with the licensee. The licensee was found in violation of the requirement for which an immediate civil penalty is warranted in accordance with on of the following California Health and Safety Code Sections 1597.58 (f)(1). You are hereby notified that a civil penalty of $2,000 is assessed for a violation that resulted in bodily injury/serious injury to a child in your care. During the inspection the licensee signed the (LIC 421D).

Exit interview was conducted and report was reviewed with the licensee. A copy of this report, along with Appeal Rights (LIC 9058 01/16) were provided during today’s inspection. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Bianca MendezTELEPHONE: (530) 895-4357
LICENSING EVALUATOR SIGNATURE:

DATE: 05/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5