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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 283010097
Report Date: 07/25/2024
Date Signed: 07/25/2024 12:48:19 PM

Document Has Been Signed on 07/25/2024 12:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:MARIN, ARACELI FCCHFACILITY NUMBER:
283010097
ADMINISTRATOR/
DIRECTOR:		MARIN, ARACELIFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 304-3422
CITY:NAPASTATE: CAZIP CODE:
94558
CAPACITY: 14TOTAL ENROLLED CHILDREN: 14CENSUS: 9DATE:
07/25/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Araceli MarinTIME VISIT/
INSPECTION COMPLETED:
01:05 PM
NARRATIVE
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On 07/25/24 Licensing Program Analyst (LPA), Cindy Castro arrived to conduct an unannounced case management deficiency visit. LPA met with Araceli Marin, Licensee (L1). Today’s census is 9 children care for and supervised by L1 and Staff (S1-S2)

During a prior visit on conducted on 04/24/24 by LPA Castro, interviews with Licensee and children (C2-C4) revealed children’s personal rights violations, CCR Code 102423. L1 stated that discipline method used with the children is sitting them on a highchair utilized for eating, as a time out. Child (C2) corroborate being sat in a chair for 5 minutes as a form of discipline. C2 also demonstrated being flinched on his cheek by S2. C2 stated that flinching occurred on one occasion. S2 stated that the discipline L1 told her to utilize was to sit the children in a highchair for 4-5 minutes. L1 stated that she has not observe any of her staff utilize physical discipline. Licensee was advised that highchairs may only be used for its intended purpose in accordance with the guidance set forth by manufacturer and may not be used in a manner that violates children’s personal rights. Licensee was reminded that discipline should be free from corporal or unusual punishment. LPA Castro provided licensee with a copy of Personal Rights Regulations and a plan of correction was discussed with Licensee.

The following violation(s) of California Code of Regulations, Title 22, Division 12, were cited during today's visit.

This report was reviewed with licensee Araceli Marin and was provided with a copy and appeal rights.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Cindy Castro
LICENSING EVALUATOR SIGNATURE: DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document is an Amendment of Original Document on 08/05/2024 11:14 AM


Created By: Cindy Castro On 07/25/2024 at 12:02 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: MARIN, ARACELI FCCH
FACILITY NUMBER: 283010097

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/16/2024
Section Cited
CCR
102423(a)(4)

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102423 Personal Rights (a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
This requirement was not met as evidenced by:
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L1 and S1-S2 will read and sign copy of Personal Rights Regulation.L1 and S1-S2 will watch will watch videos on Personal Rights on the following website:
https://ccld.childcarevideos.org/family-child-car
e-providers/ and submit a Statement of Understanding to the Department by 08/16/24.
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Based on interviews with L1 and S2. L1 and S2 reported sitting the children in a highchair, as a method of discipline. Interview also corroborates that Child 2 (C2) was flicked in the cheek by S2, which posed a potential health, safety or personal rights risk to persons in care.
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Via mail, email or fax. Email:cindy.castro@dss.ca.gov Fax: (707)588-5099

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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.
SUPERVISOR'S NAME:Alexis Hollon
LICENSING EVALUATOR NAME:Cindy Castro
LICENSING EVALUATOR SIGNATURE:
DATE: 07/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/25/2024


LIC809 (FAS) - (06/04)
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