493008276-6-22-2022-01-CC-AHON-CFNPEX-20220623111550

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493008276
Report Date: 06/22/2022
Date Signed: 06/22/2022 09:49:27 AM

Unsubstantiated

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
04/13/2022 and conducted by Evaluator Amy Strother

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20220413140708

FACILITY NAME:	ARISTIZABAL, ALETA FCCH		FACILITY NUMBER:	493008276
ADMINISTRATOR:	ARISTIZABAL, ALETA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 483-7130
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95407
CAPACITY:	14	CENSUS: 9	DATE:	06/22/2022
		UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Aleta Aristizabal		TIME COMPLETED:	10:05 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child was injured while in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA), Amy Strother made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with the Licensee, Aleta Aristizabal (L1). It has been alleged that a child was injured while in care, specifically that an infant, Child 1 (C1) sustained an injury while in care during nap time.

During the investigation, records were reviewed, and interviews were conducted. On 04/22/22 interviews were conducted with the Licensee (L1) at 10:34am, with Staff 2 (S2) at 11:22am and with three children, Child 2 (C2), Child 3 (C3) and Child 4 (C4) beginning at 11:35am. LPA interviewed Staff 1 (S1) by telephone on 05/09/22 beginning at 3:39pm.

L1 stated during the initial complaint investigation on 04/22/22 that infants are visually checked on every 15 minutes and the time documented on a sleep log for each infant in care.

Continue LIC9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2022

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-20220413140708

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: ARISTIZABAL, ALETA FCCH	FACILITY NUMBER: 493008276
	VISIT DATE: 06/22/2022

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

L1 provided a copy of the sleep logs for all infants in care during the month of April 2022. A review of Sleep Logs for C1 indicates that the time C1 was sleeping was documented every 15 minutes, each day present in April 2022. Interviews with L1, S1 and S2 corroborate that although C1 sustained an injury while in care, there is not a preponderance of evidence that the injury occurred due to a lack of supervision or a violation of personal rights. Photographs of C1’s injury were received on 4/18/22, and reviewed. LPA was unable to determine if the injury was a result of lack of supervision. Based on interviews conducted and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that an alleged violation occurred, therefore the allegation is UNSUBSTANTIATED.

There were no Title 22 deficiencies cited during today's inspection. This report was reviewed and discussed with the Licensee. Appeal Rights were provided.

Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Amy Strother	TELEPHONE: (707) 588-5077
LICENSING EVALUATOR SIGNATURE:	DATE: 06/22/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/22/2022

LIC9099 (FAS) - (06/04)

Page: 2 of 2