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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 293615577
Report Date: 12/19/2025
Date Signed: 12/19/2025 02:24:56 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2025 and conducted by Evaluator Matthew Gallo
COMPLAINT CONTROL NUMBER: 03-CC-20251016103802
FACILITY NAME:STILLWELL, JEANNETTEFACILITY NUMBER:
293615577
ADMINISTRATOR:STILLWELL, JEANNETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 265-3219
CITY:NEVADA CITYSTATE: CAZIP CODE:
95959
CAPACITY:14CENSUS: 8DATE:
12/19/2025
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Jeannette StillwellTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Provider did not maintain day care child's immunization records
INVESTIGATION FINDINGS:
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At 12:35pm on 12/19/2025, Licensing Program Analyst (LPA) Matthew Gallo arrived at the facility to deliver the findings of the complaint investigation into the above allegation. Upon arrival, LPA observed a census of 8 children consisting of 5 preschool children and 3 infants supervised by licensee's 2 adult assistants. Licensee Jeannette Stillwell arrived at the home shortly after LPA's arrival.

Throughout the course of the investigation, LPA conducted interviews and record review related to the allegation that the provider did not maintain day care children's immunization records. During a visit on 10/21/2025, LPA reviewed 10 children's records. Of the 10 records, 7 did not contain either immunization records from a doctor or a CDPH-286 immunization record sheet. The preponderance of evidence standard has been met; therefore, the allegation is SUBSTANTIATED.

Report continues on 9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
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 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/16/2025 and conducted by Evaluator Matthew Gallo
COMPLAINT CONTROL NUMBER: 03-CC-20251016103802

FACILITY NAME:STILLWELL, JEANNETTEFACILITY NUMBER:
293615577
ADMINISTRATOR:STILLWELL, JEANNETTEFACILITY TYPE:
810
ADDRESS:10663 JASPER AGATE COURTTELEPHONE:
(530) 265-3219
CITY:NEVADA CITYSTATE: CAZIP CODE:
95959
CAPACITY:14CENSUS: 8DATE:
12/19/2025
UNANNOUNCEDTIME BEGAN:
12:35 PM
MET WITH:Jeannette StillwellTIME COMPLETED:
02:35 PM
ALLEGATION(S):
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Provider did not provide adequate supervision resulting in day care child sustaining a fracture
Provider spoke to authorized representative in an inappropriate manner in the presence of day care children
Staff is falsifying documents
INVESTIGATION FINDINGS:
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At 12:35pm on 12/19/2025, Licensing Program Analyst (LPA) Matthew met arrived at the facility to deliver the findings of the complaint investigation into the above allegations. Upon arrival, LPA observed a census of 8 children consisting of 5 preschool children and 3 infants supervised by licensee's two adult assistants. Licensee Jeannette Stillwell arrived at the home shortly after LPA's arrival.

Throughout the course of the investigation, LPA conducted observation, interviews, and record review related to the following allegations:
(1) Provider did not provide adequate supervision resulting in a day care child sustaining a fracture. Through interviews, LPA was able to determine the child in question. Further interviews with relevant individuals did not support the allegation that the injury was due to a lack of supervision. Staff interviews likewise did not produce any further evidence of lack of supervision. LPA determined that the children enrolled were not suitable for interview. Based on the available evidence, the preponderance of evidence standard is not met; therefore, the allegation is UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it. Report continues on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
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 5
Control Number 03-CC-20251016103802
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: STILLWELL, JEANNETTE
FACILITY NUMBER: 293615577
VISIT DATE: 12/19/2025
NARRATIVE
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(2) Provider spoke to authorized representative in an inappropriate manner in the presence of day care children.

It was alleged that the provider spoke to an authorized representative in an inappropriate manner while daycare children were present. According to the complaint, the licensee engaged in a pointed exchange with a parent picking up their child. Based on the description of the exchange, it involved the provider speaking in a frustrated tone. Licensee's staff did not provide supporting evidence to support the allegation, and interviewed parents did not express a concern with the licensee's interactions. The preponderance of evidence standard is not met; therefore, the allegation is UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it.

(3) Staff is falsifying documents

It was alleged that the licensee did not put accurate attendance dates and hours on a form to receive child care subsidies from Sierra Nevada Children's Services (SNCS). The alleged incorrect records involved three and a half days when a child was not in care. The form was subsequently corrected for accuracy before being officially submitted. LPA reached out to a representative at SNCS, who stated that they were not aware of any recent issues similar to the allegation, and that a common misconception of providers is that they can claim days and hours when a child is on vacation. The licensee stated that they were not aware of making a mistake on the forms. The preponderance of evidence standard is not met; therefore, the allegation is UNSUBSTANTIATED, meaning that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove it.

Exit interview conducted and report was reviewed with the licensee, Jeannette Stillwell. A notice of site visit was given and must remain posted for 30 days. LPA provided appeal rights.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 03-CC-20251016103802
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: STILLWELL, JEANNETTE
FACILITY NUMBER: 293615577
VISIT DATE: 12/19/2025
NARRATIVE
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A Type B Title 22 deficiency is cited on the following LIC9099-D

Exit interview conducted and report was reviewed with the licensee, Jeanette Stillwell. A notice of site visit was given and must remain posted for 30 days. LPA provided appeal rights.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 03-CC-20251016103802
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: STILLWELL, JEANNETTE
FACILITY NUMBER: 293615577
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/19/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
01/23/2026
Section Cited
CCR
102418(g)
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The licensee shall document each child's immunizations as required by the California Code of Regulations, Title 17, Section 6070, and shall maintain such documentation for as long as the child is enrolled.

This requirement was not met as evidenced by:
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The licensee will send LPA copies of immunization records for all children enrolled by the POC due date. Records can be sent by email to matthew.gallo@dss.ca.gov
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Based on interview and record review, the licensee did not comply with the section cited above due to 7 out of 10 children's files lacking documentation of immunizations. This poses a potential health, safety, or personal rights risk to persons 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: Mai Lor
LICENSING EVALUATOR NAME: Matthew Gallo
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5