493006449-6-29-2022-01-CC-AHON-CG2UNV-20220705154430

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493006449
Report Date: 06/29/2022
Date Signed: 06/29/2022 03:59:08 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, 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
04/06/2022 and conducted by Evaluator Jennifer Velasco

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20220406122853

FACILITY NAME:	MT. TAYLOR CHILDREN'S CENTER THREE		FACILITY NUMBER:	493006449
ADMINISTRATOR:	JANAY BERRY		FACILITY TYPE:	850
ADDRESS:	812 VINEYARD CREEK DRIVE		TELEPHONE:	(707) 526-3008
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95403
CAPACITY:	29	CENSUS: 21	DATE:	06/29/2022
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Karen Guerin		TIME COMPLETED:	04:10 PM

ALLEGATION(S):

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Staff did not prevent inappropriate behaviors between day care children

INVESTIGATION FINDINGS:

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An unannounced subsequent complaint investigation visit was made to the facility by Licensing Program Analysts (LPAs), J. Velasco and S. Phouthavong to investigate allegations filed against the facility. It has been alleged that on multiple occasions staff failed to prevent inappropriate behaviors between day care children; specifically, staff failed to prevent children choking, pushing, kicking, and hitting one another. The LPAs met the facility's Co-Director Karen Guerin (D1) today and spoke with her regarding the allegations. D1 denied the allegations and stated there were no inappropriate behaviors between day care children. LPAs toured the facility inside and out, conducted interviews and requested facility documents. Today there were 21 children receiving care from three classroom staff. During the investigation, LPAs interviewed children, staff, and other witnesses; reviewed facility documents; and observed care being provided at the facility. Witness statements corroborated the allegation that staff failed to prevent children choking, pushing, kicking, and hitting one another on multiple occasions. The preponderance of evidence standard has been met; therefore, this allegation is SUBSTANTIATED. The following violation of the California Code of Regulations, Title 22; Division 6, was observed: see LIC 9099-D. This report was reviewed and discussed with D1. Appeal Rights were provided, and exit interview was conducted. All licensing reports are public information and must be made available upon request for at least three years. D1 was provided with a Notice of Site Visit (NOS) to be posted in the facility for 30 days.

Substantiated

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: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

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-20220406122853

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: MT. TAYLOR CHILDREN'S CENTER THREE	FACILITY NUMBER: 493006449
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/29/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 07/22/2022 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement has not been met as evidenced by: Multiple witness statements affirming that on multiple occasions staff failed to prevent children from choking, pushing, kicking, and hitting one another.	1 2 3 4 5 6 7	Director (D1) stated she will conduct staff training on supervision necessary to meet children's needs and provide training materials and sign-in sheet to LPA Sebastian Phouthavong at sebastian.phouthavong@dss.ca.gov. D1 also stated the facility will increase staffing
	8 9 10 11 12 13 14	This poses a potential risk to children in care.	8 9 10 11 12 13 14	sufficiently to ensure a staff is available to provide additional support as needed to meet the needs of the children.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Jennifer Velasco	TELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2022

LIC9099 (FAS) - (06/04)

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