493001553-4-17-2020-01-CC-AHON-BNY4J8-20200423190818

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493001553
Report Date: 04/13/2020
Date Signed: 04/17/2020 11:12:16 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/20/2020 and conducted by Evaluator Jennifer Velasco

COMPLAINT CONTROL NUMBER: 01-CC-20200220134610

FACILITY NAME:	DAMOS-DEURLOO, ANGELA FAMILY CHILD CARE HOME		FACILITY NUMBER:	493001553
ADMINISTRATOR:	DAMOS-DEURLOO, ANGELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 481-6898
CITY:	GUERNEVILLE	STATE: CA	ZIP CODE:	95446
CAPACITY:	12	CENSUS: 4	DATE:	04/13/2020
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Angela Damos-Duerloo		TIME COMPLETED:	02:15 PM

ALLEGATION(S):

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Licensee inappropriately denied parent entry into the facility.
Licensee transported children in an unsafe manner.

INVESTIGATION FINDINGS:

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At 1:30 p.m. on 04/13/2020, Licensing Program Analyst (LPA) Jennifer Velasco conducted an unannounced complaint inspection and met with the licensee (L1). The facility inspection was conducted via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak. It was alleged that L1 inappropriately denied a parent entry into the facility; specifically, that L1 denied a parent (A1) entry to the facility and told A1 to leave the property. It was also alleged that L1 transported children in an unsafe manner; specifically, that L1 transported children from the pick up/drop off location at the bottom of the hill to the home near the top of the hill in her vehicle without required car seats and or booster seats for children who require car seats. L1 was interviewed at 1:30 p.m. and denied the allegations, stating that while A1 was not allowed to pick up C1 at the time he desired, this was due to L1's compliance with a court order and that aside from that specific situation parents were allowed to visit the facility at any time children were in care. L1 also stated that she has never transported children in an unsafe manner and always uses the mandated car seats and booster seats for the ages and sizes of children in care.
(Continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer Velasco	TELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2020

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 01-CC-20200220134610

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: DAMOS-DEURLOO, ANGELA FAMILY CHILD CARE HOME	FACILITY NUMBER: 493001553
	VISIT DATE: 04/13/2020

NARRATIVE

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(Continued from LIC 9099)
On 02/26/2020, LPA observed 12 children being provided care and supervision by L1 and staff S1. LPA observed the morning pick-up, toured the facility, reviewed facility documents, and interviewed five adults (A2-A6), one staff (S1), and L1. LPA attempted to qualify and interview four children but was unable to qualify them. LPA interviewed one adult (A1) on 02/21/2020 and received documents from various parties on 02/27/2020, 03/05/2020, and 03/13/2020. Interviews and observations failed to corroborate the allegation that a parent was inappropriately denied entry into the facility and failed to corroborate the allegation that L1 transported children in an unsafe manner. During today’s inspection facility was toured via tele-inspection.

Although the allegations may have happened or be valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, and the findings are unsubstantiated. An exit interview was conducted. The Notice of the Tele-Inspection must be posted for 30 days.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer Velasco	TELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:	DATE: 04/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2020

LIC9099 (FAS) - (06/04)

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