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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483007757
Report Date: 12/03/2025
Date Signed: 12/03/2025 11:16:57 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/13/2025 and conducted by Evaluator Selena Mariani
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20251013122248
FACILITY NAME:CIRCLE OF FRIENDS CHILD DEVELOPMENT CENTER - P/SFACILITY NUMBER:
483007757
ADMINISTRATOR:DANIELLE HAYNESFACILITY TYPE:
850
ADDRESS:3330 DOVER AVENUETELEPHONE:
(707) 425-2717
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:88CENSUS: 44DATE:
12/03/2025
UNANNOUNCEDTIME BEGAN:
10:07 AM
MET WITH:Rose ThomasTIME COMPLETED:
10:59 AM
ALLEGATION(S):
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Staff did not provide adequate supervision, resulting in a child choking another child
INVESTIGATION FINDINGS:
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Licensing Program Analysts (LPAs), Selena Mariani and Jessica Gaumann made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with Licensee (LS), Rose Thomas. It has been alleged that staff did not provide adequate supervision, specifically that staff did not observe a child choking another child while playing in the outside play yard.

During the initial investigation inspection on 10/20/25, LPAs Mariani and Gaumann toured the facility, received documents, and met with Licensee (LS) Rose Thomas to discuss the allegation. From 10/20/25 through 12/01/25, LPAs interviewed Licensee (LS) three staff (S1, S2 and S3), a parent (P1) and attempted to interview one additional parent (P2).

During interviews conducted, all staff stated they did not witness C1 choking C2. LPAs reviewed children’s records and facility’s incident binder which revealed that C1 had choked C2 on 10/09/25 and it was reported to S3 by C2 at 10:30 am. Continue on LIC9099-C


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Selena Mariani
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
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 01-CC-20251013122248
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: CIRCLE OF FRIENDS CHILD DEVELOPMENT CENTER - P/S
FACILITY NUMBER: 483007757
VISIT DATE: 12/03/2025
NARRATIVE
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Continue from LIC9099

Based on the evidence obtained, the preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided.

Exit interview conducted, and report was reviewed with the Licensee, Rose Thomas.

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.
SUPERVISORS NAME: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Selena Mariani
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20251013122248
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: CIRCLE OF FRIENDS CHILD DEVELOPMENT CENTER - P/S
FACILITY NUMBER: 483007757
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/03/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/17/2025
Section Cited
CCR
101229(a)(1)
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No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

This requirement was not met as evidenced by:
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Licensee (LS) stated she will re-train staff on zone assignment process for outside supervision. LS stated she would submit her training notes and plan for assigning staff to each zone to the Department by 12/17/2026 via email to jessica.gaumann@dss.ca.gov and selena.mariani@dss.ca.gov
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Based on interviews with staff (LS, S1-S3) and parent (P1) conducted between 10/20/25 and 12/01/25, it has been determined that facility staff failed to provide adequate supervision resulting in C1 choking C2, which poses a potential health, safety or personal rights risk to persons 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: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Selena Mariani
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3