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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 233010187
Report Date: 08/05/2024
Date Signed: 08/05/2024 01:37:08 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 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
07/31/2024 and conducted by Evaluator Robert Maciel
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240731112618
FACILITY NAME:SANCHEZ, ALEXA FCCHFACILITY NUMBER:
233010187
ADMINISTRATOR:SANCHEZ, ALEXAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 391-2745
CITY:UKIAHSTATE: CAZIP CODE:
95482
CAPACITY:14CENSUS: 4DATE:
08/05/2024
UNANNOUNCEDTIME BEGAN:
11:54 AM
MET WITH:Alexa SanchezTIME COMPLETED:
01:51 PM
ALLEGATION(S):
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Licensee did not prevent their dog from causing injury to a child in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Robert Maciel conducted an unannounced complaint visit, and met with licensee Alexa Sanchez. It was alleged that the Licensee did not prevent their dog from causing injury to a child in care, specifically that one of the licensee's dogs jumped and scratched a child in the eye. On 8/5/24, the Licensee self-reported the incident to Community Care Licensing. The licensee was interviewed at 12:24 PM and stated that her dog jumped on a child, scratching his eye, corroborating the allegation. During today’s visit facility was toured and records were reviewed.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024
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-20240731112618
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: SANCHEZ, ALEXA FCCH
FACILITY NUMBER: 233010187
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/05/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/12/2024
Section Cited
CCR
102423(a)(2)
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(2)To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
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Licensee stated she would keep the french bulldogs in the separately fenced area in the backyard and transfer them inside when children play outside.
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Based on interview, the Licensee's dogs had jumped up on child 1 (C1) and scratched his eye which posed a potential health, safety or personal rights risk to persons in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 08/05/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2