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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 283010138
Report Date: 04/23/2025
Date Signed: 04/23/2025 02:40:42 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
02/07/2025 and conducted by Evaluator Melinda Mohr
COMPLAINT CONTROL NUMBER: 01-CC-20250207163022
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:
04/23/2025
UNANNOUNCEDTIME BEGAN:
11:21 AM
MET WITH:Tamara KinmanTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Licensee did not provide licensing report(s) documenting type A citation to parent/legal guardian.
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. LPA Mindy Mohr previously met with Director Tamara Kinman on 02/11/2025 to open the complaint and initiate the investigation.

During the course of the investigation, LPA Mohr conducted interviews and received documents pertaining to the investigation. From 02/11/2025 through 02/14/2025, interviews were conducted with Licensee (L1), Director (D1) and two adults (A24 & A25).
(Continued on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
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 3
Control Number 01-CC-20250207163022
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: 04/23/2025
NARRATIVE
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 According to L1’s interview conducted on 02/11/2025, they recently had a child start at the facility and L1 confirmed the guardian was given all the enrollment paperwork, except the reports and the Acknowledgement of Receipt of Licensing Reports’ (form LIC9224) which is required when a facility receives any Type A citation within a 12-month period. L1 stated that the guardian dropped off all enrollment paperwork when the child arrived for their first day of care and claimed the report from 02/15/2024 comes off the facility’s record soon so she did not need to add that date to the LIC9224 any longer. In addition, L1 stated she gave the guardian the reports and the LIC9224 at drop off on the child’s second day of attendance, which was after the enrollment process.
D1 stated they have had two new children start at the school recently. D1 admitted she did not give one of the newly enrolling families any of the reports for the Type A citations as she did not think she had to after 02/01/2025 as the first Type A citation was dated 02/15/2024. D1 was reminded of the requirement to provide all reports with Type A citations to the guardian for a full 12-month period, including the other reports with the Type A citations dated 06/05/2024 and 08/02/2024, D1 acknowledged all three reports were to be provided to any newly enrolling families. Adult interview (A24) stated they do not remember exactly what was given to them, but it was a couple of pages, and they were absolutely never made aware of the details.

Based on the investigation, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be substantiated. The following violations of the Health and Safety Code section 1596.895; see LIC 9099D. Licensee is also being cited a civil penalty of $250 for a repeat violation within a 12-month period. 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: 04/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20250207163022
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: 04/23/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/07/2025
Section Cited
HSC
1596.8595(c)(2)
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(2) Upon enrollment of a new child in a facility, the licensee shall provide to the parents or legal guardians of the newly enrolling child copies of any licensing report that the licensee has received during the prior 12-month period that documents any Type A citation that represents an immediate risk to the health, safety, or personal rights of children in care as set forth in paragraph (1) of subdivision (a) of Section 1596.893b.
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D1 stated they are going to pay careful attention to dates of the Type A reports and when they need to be given out to families, and will give to all families until 08/02/2025. D1 stated she knows it needs to be done.
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This requirement is not met as evidenced by: Based on interviews, both L1 and D1 confirmed guardians of a newly enrolling child did not receive copies any licensing reports that documents any Type A citations. This poses a potenial health and safety risk to the children 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: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2025
LIC9099 (FAS) - (06/04)
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