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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624252
Report Date: 07/01/2025
Date Signed: 07/01/2025 12:41:58 PM

Unsubstantiated


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
04/14/2025 and conducted by Evaluator Andrea Cortez
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20250414224843
FACILITY NAME:MINDFUL MOMENTS, INC.FACILITY NUMBER:
343624252
ADMINISTRATOR:SIMMONS, TIFFANYFACILITY TYPE:
850
ADDRESS:750 N STREETTELEPHONE:
(916) 626-2739
CITY:SACRAMENTOSTATE: CAZIP CODE:
95814
CAPACITY:72CENSUS: 28DATE:
07/01/2025
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Ashley WinnTIME COMPLETED:
12:50 PM
ALLEGATION(S):
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9
Personal Rights-Staff behavior poses as a risk to the daycare children-
Ratio
INVESTIGATION FINDINGS:
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On 07/01/2025 at approximately 9:45 AM, License Program Analysts (LPAs) Andrea Cortez and Pa Dao Vang conducted an unannounced complaint inspection to deliver findings on the above-mentioned allegations. LPA Vang observed preschool children-to-staff ratio of 28:4 while LPA Andrea was setting up to meet with the Licensee Ashley Winn. LPAs explained the purpose of inspection and allegations of Staff behavior poses as a risk to the daycare children and Staff are operating out of ratio.

During the complaint investigation, LPA observed the preschool room in ratio while children were interacting during indoor playtime. LPA obtained teachers and children rosters to prepare for investigation. LPA interviewed children, parents and staff members. According to most parent interviews there are no concerns with ratios or Staff behaviors. In addition, children interviews revealed no concerns with the above allegations. And Staff interviews verified parent statements.

Continued page LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
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 03-CC-20250414224843
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: MINDFUL MOMENTS, INC.
FACILITY NUMBER: 343624252
VISIT DATE: 07/01/2025
NARRATIVE
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Therefore, although the alleged violations may have happened or are valid, the preponderance of evidence standard has not been met to fully prove or disprove that it did or did not occur, therefore they are unsubstantiated. There is no deficiency issued today. An exit interview was conducted, notice of site visit, and appeal rights were provided to Licensee Ashley Winn. Notice of site visit will be posted for 30 consecutive days.
SUPERVISORS NAME: Amanda Blesi
LICENSING EVALUATOR NAME: Andrea Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 2