173009857-7-9-2021-01-CC-LLEI-C4V35A-20210712175626

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 173009857
Report Date: 07/09/2021
Date Signed: 07/09/2021 09:23:11 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,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/05/2021 and conducted by Evaluator Kevin O'Connell

COMPLAINT CONTROL NUMBER: 01-CC-20210205135423

FACILITY NAME:	BROWN, CARRIE FCCH		FACILITY NUMBER:	173009857
ADMINISTRATOR:	BROWN, CARRIE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 245-9154
CITY:	CLEARLAKE	STATE: CA	ZIP CODE:	95422
CAPACITY:	14	CENSUS: 0	DATE:	07/09/2021
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Carrie Brown, Licensee		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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Licensee is impaired while children are in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Kevin O’Connell, conducted a subsequent complaint inspection on 7/9/2021 at 08:50am for the purpose of delivering the findings regarding the above allegation. LPA previously met with the Licensee (L) on 2/16/2021 via a tele-inspection due to the COVID-19 pandemic to discuss the above allegation, initiate the investigation, and obtain facility rosters of children and staff. Multiple referrals were reported alleging that the Licensee was impaired while children are in care, specifically because of Licensee’s unusual behavior and irregular speech patterns. L denied the allegation on 2/16/21 at 10:05am stating that it was false and that she was going through an personal issue unrelated to the facility which she believes was the basis for this complaint.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

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-20210205135423

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: BROWN, CARRIE FCCH	FACILITY NUMBER: 173009857
	VISIT DATE: 07/09/2021

NARRATIVE

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Through the course of the investigation, starting from 02/16/21 through 06/30/21, LPA interviewed Licensee, four adults, eight parents, and attempted to interview three children. Some children were not verbal, too young to interview, not available, or did not qualify to be interviewed. Two adults (A1, A3) and one child (C3) did report observing L smoking marijuana in a separate shed located near the home and one parent (P3) heard of L smoking marijuana, however, other statements provided by two adults and eight parents did not report any corroborating evidence of L smoking in the facility or being impaired while children were in care. Parent statements further noted that their children were happy or excited to go to the facility and did not appear to be fearful or withdrawn from L or other staff. Parent statements did not reveal any negative experiences regarding L’s ability to provide care and supervision. As such, there is not enough evidence to corroborate that L is impaired while children were in care or that it affected the care and supervision provided to the children.

Based on the investigation, although the allegation may have happened or is valid, there’s not a preponderance of evidence to support the allegation that the Licensee was impaired while children were in care and therefore, the allegation is unsubstantiated. This report was discussed and reviewed with L and an Exit interview was conducted with L. L’s signature was not recorded on this Complaint Investigation Report (CIR), however; L was provided with a copy of this report, and L’s confirmation of read receipt is on file. Notice of Site Visit shall be posted for 30 days. There were no title 22 deficiencies cited during this visit. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:	DATE: 07/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/09/2021

LIC9099 (FAS) - (06/04)

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