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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 233010701
Report Date: 03/28/2025
Date Signed: 03/28/2025 02:45:18 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC 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
12/30/2024 and conducted by Evaluator Robert Maciel
COMPLAINT CONTROL NUMBER: 01-CC-20241230164656
FACILITY NAME:MACIAS BALLESTEROS, ERICKA FCCHFACILITY NUMBER:
233010701
ADMINISTRATOR:ERICKA MACIAS BALLESTEROSFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 391-8785
CITY:UKIAHSTATE: CAZIP CODE:
95482
CAPACITY:14CENSUS: 8DATE:
03/28/2025
UNANNOUNCEDTIME BEGAN:
11:27 AM
MET WITH:Ericka Macias BallesterosTIME COMPLETED:
02:54 PM
ALLEGATION(S):
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Licensee is not following safe sleep guidelines for children in care.

Licensee operated beyond the terms of the license.
INVESTIGATION FINDINGS:
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On 3/28/25, Licensing Program Analyst (LPA) Robert Maciel conducted an unannounced follow-up complaint visit, and met with Licensee Ericka Macias Ballesteros. It was alleged that the Licensee is not following safe sleep guidelines for children in care and that the Licensee operated beyond the terms of the license.

During today's visit, LPA toured the facility and requested facility documents. When LPA arrived at 11:27 AM, the only adult present was the assistant, Jose Macias Corona. The Licensee, Ericka Macias Ballesteros arrived at the home at 11:35 AM. LPA observed 8 children in care, 4 of whom were infants. Assistant stated that the Licensee had left a few minutes before LPA arrived at 11:27 AM to meet with a parent to obtain facility documents. In the nap room, LPA observed an infant (C13) sleeping in a play pen with a blanket. Licensee stated that the infant needs a blanket to fall asleep and once the child is asleep, the blanket is removed. LPA observed the assistant remove the blanket from the playpen.
Continued on LIC9099C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC 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
12/30/2024 and conducted by Evaluator Robert Maciel
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20241230164656

FACILITY NAME:MACIAS BALLESTEROS, ERICKA FCCHFACILITY NUMBER:
233010701
ADMINISTRATOR:ERICKA MACIAS BALLESTEROSFACILITY TYPE:
810
ADDRESS:1416 SOUTH STATE ST. #10TELEPHONE:
(707) 391-8785
CITY:UKIAHSTATE: CAZIP CODE:
95482
CAPACITY:14CENSUS: 8DATE:
03/28/2025
UNANNOUNCEDTIME BEGAN:
11:27 AM
MET WITH:Ericka Macias BallesterosTIME COMPLETED:
02:54 PM
ALLEGATION(S):
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3
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9
Licensee left day-care child in a soiled diaper for a long period of time.

Licensee did not properly feed an infant in care.
INVESTIGATION FINDINGS:
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On 3/28/25, Licensing Program Analyst (LPA) Robert Maciel conducted an unannounced follow-up complaint visit, and met with Licensee Ericka Macias Ballesteros. It was alleged that the Licensee left day-care child in a soiled diaper for a long period of time and the Licensee did not properly feed an infant in care.

During today's visit, LPA toured the facility and requested facility documents. Licensee, assistants, and adults were interviewed from 01/02/25 to 03/27/25 which do not corroborate the allegations.

Although the allegation may have happened or is valid, there is not a preponderance of the evidence to prove that the alleged violation occurred, and the findings are unsubstantiated. An exit interview was conducted with Licensee Ericka Macias Ballesteros. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 01-CC-20241230164656
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: MACIAS BALLESTEROS, ERICKA FCCH
FACILITY NUMBER: 233010701
VISIT DATE: 03/28/2025
NARRATIVE
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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. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 01-CC-20241230164656
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: MACIAS BALLESTEROS, ERICKA FCCH
FACILITY NUMBER: 233010701
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/28/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/18/2025
Section Cited
CCR
102416.5(b)(2)
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102416.5(b): ...the maximum number of children for whom care may be provided at any one time, including children under age 10 who reside at the licensee's home, shall be one of the following:
(b) Six children, no more than three of whom may be infants...
This regulation was not met as evidenced by:
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LPA gave Licensee a copy of the Staffing Ratio and Capacity regualtions who stated she would read them and submit a written statement attesting to her understanding of the regulations to LPA by email at robert.maciel@dss.ca.gov.
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Based on LPA observation, there were 8 children in care, 4 of whom were infants, when only one adult was present in the home which poses a potential risk to the health and safety of children in care.
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Type B
04/18/2025
Section Cited
CCR
102425(b)
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102425(b): Cribs or play yards shall be free from all loose articles and objects.

This regulation was not met as evidenced by:
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LPA gave Licensee a copy of the Infant Safe Sleep regualtions who stated she would read them and submit a written statement attesting to her understanding of the regulations to LPA by email at robert.maciel@dss.ca.gov.
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Based on LPA observation, there was an infant (C13) who was sleeping in a play pen with a blanket.
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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: Erin Virrueta
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 03/28/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/28/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 4