493008417-5-29-2019-01-CC-AHON-BCMQSS-20190529122600

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493008417
Report Date: 05/22/2019
Date Signed: 05/29/2019 10:00:07 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
03/18/2019 and conducted by Evaluator Jennifer Velasco

COMPLAINT CONTROL NUMBER: 01-CC-20190318134735

FACILITY NAME:	ROSS, SHAELA FCCH		FACILITY NUMBER:	493008417
ADMINISTRATOR:	ROSS, SHAELA & ROBYN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 483-9741
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95405
CAPACITY:	14	CENSUS: 13	DATE:	05/22/2019
		UNANNOUNCED	TIME BEGAN:	11:20 AM
MET WITH:	Shaela Ross		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee is operating out of ratio.

INVESTIGATION FINDINGS:

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

A subsequent complaint investigation inspection was conducted at the facility by Licensing Program Manager (LPM) A. Hollon and Licensing Program Analyst (LPA) J. Velasco. It was alleged that the facility is operating out of ratio; specifically, that for a period of six weeks in February and March 2019, there were on subsequent Wednesdays as many as six infants under two years of age receiving care in the facility at the same time. LPA met with the licensee (L1) on 03/20/19 at 1:45 p.m. to discuss the allegation. L1 denied the allegation and stated that the facility always operates within its licensed capacity and ratio requirements. L1 stated there were in care two children (C4 and C5) over 24 months old, both of whom appeared to be younger than 24 months old. On 03/20/2019, LPA toured the facility, obtained the facility roster, and examined children's files. LPA verified that the two children, C4 and C5, were over 24 months old. LPA also obtained a written schedule of infants in care and observed that the infants were in care on staggered schedules. An interview with staff S2 was also conducted on 03/20/19 beginning at 1:22 p.m. Interview conducted with staff did not corroborate that the facility operated out of ratio in 02-03/19 or at any time before or after that date. Staff S2 stated that the facility always maintains adequate staffing and ratios.
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: 05/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

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-20190318134735

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: ROSS, SHAELA FCCH	FACILITY NUMBER: 493008417
	VISIT DATE: 05/22/2019

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

Continued from LIC 9099
During an inspection on 03/20/19, LPA observed 13 children, of which three were infants, being supervised by L1 and one staff (S2). The licensee was operating within ratio on 03/20/2019. During today's inspection, LPA observed 13 children, of which four were infants, being supervised by L1 and two staff. The licensee was operating within ratio during today's inspection.
During the investigation, four child care clients (C1-C4) were qualified and interviewed. Interviews with childcare clients C1-C4 did not corroborate that the facility has operated out of ratio at any time. During the investigation, one parent interview did not corroborate that the facility has operated out of ratio at any time.

Based on available information, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is unsubstantiated.

All licensing reports are public information and must be made available upon request for at least three years. There were no Title 22 deficiencies cited during today's inspection. 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: Jennifer Velasco	TELEPHONE: (707) 588-5044
LICENSING EVALUATOR SIGNATURE:	DATE: 05/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 2