493008329-2-5-2021-01-CC-AHON-BYGPBX-20210222101100

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493008329
Report Date: 02/02/2021
Date Signed: 02/05/2021 02:18:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2020 and conducted by Evaluator Mary Trinh

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20201209153614

FACILITY NAME:	HARTLEY, LISA FCCH		FACILITY NUMBER:	493008329
ADMINISTRATOR:	HARTLEY, LISA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 539-5028
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95409
CAPACITY:	14	CENSUS: 6	DATE:	02/02/2021
		ANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Lisa Hartley, Licensee		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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-Unqualified staff left alone with daycare children.
-Day care children left unattended during nap time.
-Day care children have access to hazardous objects.
-Converted room unattached to home being used for care.

INVESTIGATION FINDINGS:

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This is an amended report from LIC 9099D dated on 01/25/2021. Due to COVID-19 a tele-visit using FaceTime was conducted by Licensing Program Analyst, (LPA) Mary Trinh with Lisa Hartley, Staff 1 (S1) to deliver complaint finding. It has been alleged that Unqualified staff left alone with day care children, Day care children left unattended during nap time, Day care children have access to hazardous objects and Converted room unattached to home being used for care.
On today's visit dated 02/02/2021 at 1:40 pm a tour of the main home and converted room was given by S1. LPA Trinh observed four children napping in the main home. The converted room was observed to have no children present. The converted room had two large cabinets. S1 will email to LPA Trinh updated Children's Roster.
On 12/10/2020 at 3:15 pm, LPA Trinh interviewed Licensee (S1) who denied the allegations, stating that Staff 3 (S3) was in process of taking a CPR/ First Aid course, children are supervised during nap time and that portable heater in shed is not turned on when children are in the shed.
On 12/10/2020 at 3:40 pm a tour of the day care home was given by S1. The shed was toured and a baby monitor and portable heater was on a table. LPA Trinh observed 3 Toddlers and 6 Pre School age children. There were two staff present who were supervising the children in the backyard while the children were eating snacks.
Continued...

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021

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 4

Control Number 01-CC-20201209153614

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: HARTLEY, LISA FCCH	FACILITY NUMBER: 493008329
	VISIT DATE: 02/02/2021

NARRATIVE

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It has been alleged that Unqualified staff left alone with day care children, specifically that S3 is not CPR/ First Aid certified. On 01/15/2021 at 4:00 pm, LPA Trinh interviewed S3 and confirmed that she was never enrolled or is up to date with CPR/ First Aid requirement.
It has been alleged that Day care children left unattended during nap time. LPA Trinh interviewed S2 on 01/20/2021 at 4:30 pm. Parent 1 (P1) was interviewed on 01/20/2021 at 2:50 pm. S2, S3 and P1 confirmed that all the children will nap in the shed and only a baby monitor is present.
It has been alleged that Day care children have access to hazardous objects, specifically a portable heater. S2 and S3 confirmed that there was a portable heater used in the shed and they would have to block the device away from the children.
It has been alleged that Converted room unattached to home being used for care, specifically that children are in the shed all day. It has been confirmed by S2, S3 and Parents interviewed that the shed has been used as the main area for day care.

Based on the information gathered during this investigation, there is a preponderance of evidence to prove that the above allegations did happen and occurred. The allegations are determined to be Substantiated. See LIC 9099D.
This report and Appeal Rights will be emailed and mailed to Lisa Hartley.

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 01-CC-20201209153614

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: HARTLEY, LISA FCCH	FACILITY NUMBER: 493008329
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/02/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed Type B 02/04/2021 Section Cited CCR 102417(g)(1)	1 2 3 4 5 6 7	102417- Opreation of a Family Child Care Home (g) The home shall be free from defects or conditions which might endanger a child. Safety precautions shall include but not be limited to: (1) Fireplaces and open-face heaters shall be screened to prevent access by children. The home shall contain a fire extinguisher and smoke detector device which meet standards established by the State Fire Marshal. This requirement is not met as evidenced by LPA Trinh interviewed S2 and S3 who confirmed that a portable heater was used and turned on in the shed when children were present.	1 2 3 4 5 6 7	Use of the detached child care room has ceased and can only resume if a fire clearance is granted allowing use with a safe heat source. Fire inspection must occur with the heat source present and screened to demonstrate prevention of access by children.
Type B 02/04/2021 Section Cited CCR 102416(c)	1 2 3 4 5 6 7	102416-Personnel Requirement(c) The licensee and other personnel as specified shall complete training on preventive health practices, including pediatric cardiopulmonary resuscitation and pediatric first aid, pursuant to Health and Safety Code Section 1596.866. This requirement was not met as evidenced by on 01/15/2021, LPA Trinh interviewed S3 who stated confirmed she was never enrolled or in the process of taking CPR/ First Aid course.	1 2 3 4 5 6 7	At least one staff who has a current certificate in pediatric CPR/First Aid will be available at all times when children are present.
	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: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2021

LIC9099 (FAS) - (06/04)

Page: 3 of 4

Control Number 01-CC-20201209153614

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: HARTLEY, LISA FCCH	FACILITY NUMBER: 493008329
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/02/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Request Denied Type A 02/04/2021 Section Cited CCR 102416.3(a)(2)	1 2 3 4 5 6 7	102416.3 Alterations to Existing Buildings or Grounds (a) Prior to making alterations or additions to a family child care home or grounds, the licensee shall notify the Department of the proposed changed, including, but not limited to, the following: (2) Room additions to the family child care home. This requirement is not met as evidenced by LPA Trinh interviewed S2, S3 and Parents who confirmed that the shed has been used as the main area for day care.	1 2 3 4 5 6 7	Use of the detached child care room has ceased and can only resume if a fire clearance is granted. If a fire clearance is granted, the detached room cannot be used as the main day care space, it can only be used in addition to the main Family Child Care Home.
Request Denied Type A 02/04/2021 Section Cited CCR 102425(j)(4)	1 2 3 4 5 6 7	102425- Infant Safe Sleep (j) The provider shall supervise infants while they are sleeping and adhere to the following requirements: (4) The provider shall be near enough to the sleeping infant to be able to hear them wake up. This requirement was not met as evidenced on 01/20/2021 S2, S3, and P1 confirmed that children sleep in the shed unsupervised, with only a baby monitor.	1 2 3 4 5 6 7	Licensee shall review the FCCH Safe Sleep regulations and email to LPA Trinh that it has been reviewed. This shall be emailed to LPA Trinh by 02/05/2021. FCCH Safe Sleep regulations will be followed.
	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: Mary Trinh	TELEPHONE: (707) 588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 02/04/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/04/2021

LIC9099 (FAS) - (06/04)

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