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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 283010138
Report Date: 02/11/2025
Date Signed: 02/11/2025 01:35:13 PM

Unsubstantiated


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
11/25/2024 and conducted by Evaluator Melinda Mohr
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20241125161700
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: 10DATE:
02/11/2025
UNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:Tamara KinmanTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Staff falsified documentation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mindy Mohr made an unannounced complaint investigation visit today and met with Director Tamara Kinman for the purpose of delivering findings for the above allegation. It was alleged staff falsified documentation specifially the LIC9224. LPA Mohr previously met with Director Tamara Kinman on 12/04/2024 to open the complaint.
During the course of the investigation, LPA Mohr conducted interviews and received documents pertaining to the investigation. From 12/04/2024 through 01/16/2025, interviews were conducted with Licensee (L1), Director (D1), three adults (A7, A21 & A22) and adult interviews were attempted.

Continued on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
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 2
Control Number 01-CC-20241125161700
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: 02/11/2025
NARRATIVE
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Licensee (L1) and Director (D1) both denied the allegation. D1 stated she observed all parents sign the LIC9224, while L1 stated D1 was responsible for obtaining the signatures of parents for the LIC9224. Adults A7 and A21 both confirm the signature on the LIC9224 was theirs, while A22 confirmed the signature on the LIC9224 was not their signature.

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: 02/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2