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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 283010138
Report Date: 10/07/2024
Date Signed: 10/07/2024 11:54:52 AM

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
07/12/2024 and conducted by Evaluator Melinda Mohr
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240712171437
FACILITY NAME:HOPPER CREEK MONTESSORIFACILITY NUMBER:
283010138
ADMINISTRATOR:TAMARA KINMANFACILITY TYPE:
850
ADDRESS:2141 2ND STREETTELEPHONE:
(707) 231-8768
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:35CENSUS: 11DATE:
10/07/2024
UNANNOUNCEDTIME BEGAN:
10:02 AM
MET WITH:Tamara KinmanTIME COMPLETED:
12:01 PM
ALLEGATION(S):
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Facility did not provide safe environment for napping child
Facility did not follow child's dietary needs
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mindy Mohr and Licensing Program Manager (LPM) Leslie Lepori made an unannounced complaint investigation visit today and met with Director Tamara Kinman for the purpose of delivering findings for the above allegations. LPA Mindy Mohr previously met with Director Tamara Kinman on 07/17/2024 to open the complaint.

During the course of the investigation, LPA Mohr conducted interviews, received documents, and made observations. From 07/12/2024 through 09/17/2024, interviews were conducted with Licensee (L1), one staff (S1) and ten adults (A2, A7, A11 - A15 & A18-A20). Children interviews were attempted.

(continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
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 6
Control Number 01-CC-20240712171437
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: HOPPER CREEK MONTESSORI
FACILITY NUMBER: 283010138
VISIT DATE: 10/07/2024
NARRATIVE
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 L1 stated that if a child falls asleep before nap time, they will place the child on a cot to sleep, and there is also a mat kept outside for children to sleep on if they fall asleep while outside. L1 also stated that a child (C5) fell asleep on her lap while outside and the child was immediately taken inside to sleep on a cot. S1 stated if a child falls asleep, they will leave the children where they fell asleep, unless it is unsafe such as the play structure or in a high traffic area. For example, if a child fell asleep with their head on the table they would leave the child there. One time a child was left lying in the sun for about 10 to 15 minutes but S1 claimed the child was not asleep.

Adult interviews (A2 & A15) both state they have observed children fall asleep while outside at the picnic table with the child’s head on the table and their body sitting upright, but the children were not moved to cots. A15 stated they observed C5 sleeping against L1, to which L1 did not move C5 and kept C5 leaning up against L1 while asleep. In addition, both A2 and A15 stated they observed multiple times children had either fallen asleep on the floor or the couch and were not moved to mats or a safe area. A7 stated they received a text around the first part of June showing their child sleeping outside in the sun while directly laying on the gravel and was advised they were there for about 15 minutes before being checked. Regulation requires a facility to provide safe and comfortable accommodations to meet a child’s needs.

L1 stated there are two children with food restrictions, one child (C12) has a nut allergy and the other child (C1) has a diary allergy. C1’s guardian confirmed they verbally told staff that C1 was not to have any dairy. C12’s guardian stated that C12 has a severe nut allergy as well as an allergy to cashews and pistachios and staff should not be giving C12 any nuts. L1 claimed that neither C1 or C12 have been given food they are not allowed to have, specifically C12 has never had a nut while at the facility, “we are very careful about that”. Furthermore, L1 stated when C12 is here, the facility does nut-free and all the packaging at the facility says nut free. S1 stated they take cues from the parents regarding children's dietary needs. They talk to the parents and ask them what they want and not want them to feed their children. S1 further confirmed they did have one child C1 who could not have dairy and that C1 was not given dairy. They also have a child (C12) with a peanut allergy but have never given C12 peanut butter.
(Continued on LIC9099-C)
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 01-CC-20240712171437
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: HOPPER CREEK MONTESSORI
FACILITY NUMBER: 283010138
VISIT DATE: 10/07/2024
NARRATIVE
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According to adult interviews (A2, A13 & A15), one day L1 was eating pistachios and C12 ate one. A7 stated they received a list of items C1 was given to eat while at the facility, which were all foods their child should not eat due to their allergy. Record review confirmed that both C1 and C12’s files had documentation that C1 was not to consume diary and C12 was not to consume any nut products.

LPA’s observations revealed there were multiple food items that contain nuts, as well as peanut butter stored on a shelf at child level in the kitchen. The kitchen is an on limits area of the facility, and children walk in and out of that room multiple times a day.

Therefore, based on the investigation, the preponderance of evidence standard has been met. Therefore, the above allegations are found to be substantiated. The following violations of the California Code of Regulations, Title 22; Division 12: see LIC 9099D. Appeal rights were provided.

Exit interview was conducted, and report reviewed with Director Tamara Kinman.
A notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 6
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
07/12/2024 and conducted by Evaluator Melinda Mohr
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240712171437

FACILITY NAME:HOPPER CREEK MONTESSORIFACILITY NUMBER:
283010138
ADMINISTRATOR:TAMARA KINMANFACILITY TYPE:
850
ADDRESS:2141 2ND STREETTELEPHONE:
(707) 231-8768
CITY:NAPASTATE: CAZIP CODE:
94559
CAPACITY:35CENSUS: 11DATE:
10/07/2024
UNANNOUNCEDTIME BEGAN:
10:02 AM
MET WITH:Tamara KinmanTIME COMPLETED:
12:01 PM
ALLEGATION(S):
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Facility did not follow reporting requirements
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mindy Mohr and Licensing Program Manager (LPM) Leslie Leopri made an unannounced complaint investigation visit today and met with Director Tamara Kinman for the purpose of delivering findings for the above allegation. LPA Mindy Mohr previously met with Director Tamara Kinman on 07/17/2024 to open the complaint.
During the course of the investigation, LPA Mohr conducted interviews, received documents, and made observations. From 07/12/2024 through 09/17/2024, interviews were conducted with Licensee (L1), one staff (S1) and ten adults (A2, A7, A11 - A15 & A18-A20).
L1 denied that there have not been any illnesses at the facility, specifically they have never had a case of hand, foot and mouth. Additionally, L1 stated “we have been doing fantastic with no illnesses here”. Interview with S1 revealed the facility had one case of pink eye, a couple possible cases of hand, foot and mouth with one additional case being confirmed, however the child was not on campus while contagious, so the facility did not inform parents of the confirmed case of hand, foot and mouth.
(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
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 6
Control Number 01-CC-20240712171437
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: HOPPER CREEK MONTESSORI
FACILITY NUMBER: 283010138
VISIT DATE: 10/07/2024
NARRATIVE
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 Adult interviews (A13 – A15 & A18-A20) all state they were not made aware of any illness going through the facility. A18 did state they had heard two children were diagnosed with hand, foot and mouth but staff did not provide much information. A14 stated COVID was going around the school in the spring, and that they were informed of hand, foot mouth at either drop off or pick, but was not given an official document stating a child had it.

Based on the information gathered during this investigation, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the
allegation occurred and therefore is determined to be unsubstantiated. There were no Title 22 deficiencies cited. This report was reviewed and discussed with the Director, Tamara Kinman. Appeal rights were provided. Notice of Site Visit shall be posted for 30 days from today's visit. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 6
Control Number 01-CC-20240712171437
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: HOPPER CREEK MONTESSORI
FACILITY NUMBER: 283010138
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/07/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/21/2024
Section Cited
CCR
101229(7)(B)
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Modified diets prescribed by a child's physician as a medical necessity shall be provided.
(B) A child shall not be served any food to which the child's record indicates he/she has an allergy.
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Director stated she will write a written statement regarding food allergies and their procedure. Director will email to Melinda.mohr@dss.ca.gov
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This requirement is not met as evidenced by:
During interview and record review two children C1 and C12 were served items in which they are not to consume.
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Type B
10/21/2024
Section Cited
CCR
101223(a)(2)
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The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evidenced by:
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Director stated when a child falls asleep they will have a designated area to have the child sleep. Director will email the plan to LPA at Melinda.mohr@dss.ca.gov
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Based on interviews multiple children been observed sleeping in areas other than those designated for napping.
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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: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 10/07/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/07/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 6