493008960-3-29-2022-01-CC-AHON-CD3NWN-20220401104947

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493008960
Report Date: 03/29/2022
Date Signed: 03/29/2022 04:40:15 PM

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
01/19/2022 and conducted by Evaluator Yang Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20220119120733

FACILITY NAME:	HANSEN, JENNIFER FCCH		FACILITY NUMBER:	493008960
ADMINISTRATOR:	HANSEN, JENNIFER		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 360-5107
CITY:	WINDSOR	STATE: CA	ZIP CODE:	95492
CAPACITY:	14	CENSUS: 6	DATE:	03/29/2022
		UNANNOUNCED	TIME BEGAN:	01:33 PM
MET WITH:	Jennifer Hansen		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility operating out of ratio

INVESTIGATION FINDINGS:

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An unannounced follow-up complaint investigation visit to the facility was made today by Licensing Program Analyst (LPA), Y. Yang to deliver complaint investigation findings. It was alleged that the facility is operating out of ratio. Specifically, it was alleged that the licensee is providing care and supervision for more than eight children at one time without an assistant at the home.

The LPA met with the facility’s licensee, Jennifer Hansen today at 01:34pm discuss the investigation findings. A tour of the facility was conducted at 01:40pm today. There were 9 children present at the facility being supervised by two staff members. The initial investigation visit was made by the LPA on 01/24/22. There were 10 children present and two staff members during this visit. The facility was operating within ratio during both inspection visits.

Continued on LIC 9099-C

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alexis Hollon	TELEPHONE: (707) 588-5036
LICENSING EVALUATOR NAME: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022

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-20220119120733

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: HANSEN, JENNIFER FCCH	FACILITY NUMBER: 493008960
	VISIT DATE: 03/29/2022

NARRATIVE

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During the initial investigation visit on 01/24/22, the licensee denied the allegation and stated that the facility is following all ratio and capacity requirements set by Title 22 regulations. The licensee stated that anytime there are more than eight children present, an assistant is always present helping her out. The licensee stated that she currently utilizes two assistants at her facility. The licensee stated that she is familiar with the ratio regulations for a large family childcare home.

During the investigation, interviews were conducted with the childcare facility’s clients and current and former staff members S2-S5 on 01/24/22 and 03/21/22. Current and former staff members that were interviewed all corroborated the licensee’s statements. The individuals that were interviewed all stated that they have never observed the licensee providing care and supervision for more than eight children alone or operate over ratio. The clients that were interviewed all stated that they have not observed the licensee operating over ratio.

Based on the information gathered during this investigation, there is not a preponderance of evidence to support the allegation. The allegation is determined to be unsubstantiated. There were no Title 22 deficiencies cited. This report was reviewed and discussed with the facility’s licensee, Jennifer Hansen. 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: Yang Yang	TELEPHONE: 707-588-5026
LICENSING EVALUATOR SIGNATURE:	DATE: 03/29/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2022

LIC9099 (FAS) - (06/04)

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