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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483010050
Report Date: 07/12/2024
Date Signed: 07/12/2024 04:53:53 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/04/2024 and conducted by Evaluator Elpidia Hernandez Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240404101350
FACILITY NAME:PAYNE, JESSICA FCCHFACILITY NUMBER:
483010050
ADMINISTRATOR:PAYNE, JESSICAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 655-6210
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:14CENSUS: 2DATE:
07/12/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee Jessica PayneTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Licensee inappropriately yells and screams at the daycare children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Elpidia Hernandez Torres, conducted a subsequent complaint investigation inspection on 07/12/24 at 03:00PM for the purpose of delivering the findings regarding the above allegation. LPA previously met with Licensee on 04/10/24 to discuss the purpose of the visit and request personnel records and children roster. It was alleged that licensee inappropriately yells and screams at the daycare children.

During the course of the investigation, interviews were conducted with Licensee, staff, 8 children and 5 guardians between 04/09/2024 and 06/18/2024. Licensee reported she never yells at children directly but has yelled “hey” to get children’s attention. One staff’s interview revealed they never saw or heard licensee yell at day care children, but has heard licensee yell at her own kids to clean up their stuff.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
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 5
Control Number 01-CC-20240404101350
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: PAYNE, JESSICA FCCH
FACILITY NUMBER: 483010050
VISIT DATE: 07/12/2024
NARRATIVE
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Two guardians interviews revealed they heard licensee yell; one guardian reported they heard licensee yell to get children’s attention or to prevent an accident, another guardian reported they heard licensee yelling at her kids to close the door. Children interviews corroborated licensee yells at children when they are ‘bad’ and when they don’t listen. One child reported licensee uses a ‘mean voice’ to yell “Come on”. Another child reported licensee will yell “Come Here”, and “Stop it” really loud. Another child reported licensee yells at children in the car. Another child reported licensee yells “sit down”, when the child was walking past the licensee. Evidence received revealed licensee yelled “what did I just tell you? What did your mom say?” to a child, and the other children stopped playing to stare back and forth at the licensee and the child.

Based on interviews and evidence received the preponderance of evidence standard has been met and the above allegation is found to be substantiated. The California Code of Regulations, Title 22, Division 12 & Chapter 1, section 102423(a)(4) is being cited on attached LIC 9099D . This report was reviewed with the Licensee and an exit interview was conducted. Licensee’s signature was recorded on this Complaint Investigation Report (CIR); a copy was provided . Notice of Site Visit shall be posted for 30 days. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 01-CC-20240404101350
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: PAYNE, JESSICA FCCH
FACILITY NUMBER: 483010050
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/12/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/26/2024
Section Cited
CCR
102423(a)(4)
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102423(a)(4)Each child receiving services from a family child care home shall have certain rights. . .Personal Rights, To be free from. . . humiliation, intimidation, ridicule, coercion, threat, mental abuse. . . This was not met as evidence by. . .
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License reported you use your voice when it imposes an immediate danger like biting and hitting with objects.
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. . .Based on interviews conducted and evidence received the licensee yelled at a children. This causes a potential health and safety risk to children in care.
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LPA suggested licensee reach out to the child care advocate program and TSP to help with tools on personal rights.
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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: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
04/04/2024 and conducted by Evaluator Elpidia Hernandez Torres
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240404101350

FACILITY NAME:PAYNE, JESSICA FCCHFACILITY NUMBER:
483010050
ADMINISTRATOR:PAYNE, JESSICAFACILITY TYPE:
810
ADDRESS:1500 GARFIELD STREETTELEPHONE:
(707) 655-6210
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:14CENSUS: 2DATE:
07/12/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Licensee Jessica PayneTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Licensee does not provide adequate supervision
Licensee inappropriately grabs the daycare children
Licensee does not provide adequate food service
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Elpidia Hernandez Torres, conducted a subsequent complaint investigation inspection on 07/12/2024 at 03:45PM for the purpose of delivering the findings regarding the above allegation. LPA previously met with Licensee on 04/10/24 to discuss the purpose of the visit and request personnel records and children roster. It was alleged that Licensee does not provide adequate supervision, Licensee inappropriately grabs the daycare children, and Licensee does not provide adequate food service.

During the course of the investigation, interviews were conducted with Licensee, staff (S1), 8 children (C1-C8) and 5 guardians ( G1-G5) between 04/09/2024 and 06/18/2024. Licensee reported this complaint about supervision probably came from and incident that happened in the day care room, where her child kicked another child’s ipad and licensee was in the kitchen. Licensee reported supervision means interacting with children and watching them. Licensee reported she has never put her hands on a child except to take their hands and lead them. And Licensee reported she provides all the meals, but families are welcome to provide their own meals too. Staff (S1) reported when they are present there is adequate supervision and has seen licensee grab children by their hands to help them wash their hands. S1 further reported, when they are present, they make the meals so the children eat the meals provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20240404101350
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: PAYNE, JESSICA FCCH
FACILITY NUMBER: 483010050
VISIT DATE: 07/12/2024
NARRATIVE
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Interviews revealed licensee takes the children out on field trips to the park, to water parks, to arcade parks, and to the movie theaters. It was alleged during an outing to the movie theater children were sent to the bathroom alone without adult supervision. One child’s interview (C3) revealed children asked to go to the bathroom and licensee allowed them to go in a group. Another child (C4) reported they had to go to the bathroom, but licensee was already at the bathroom taking another group of kids, so they asked the other staff member if they could go, and they were allowed to go in a group again. Children interviews indicated that when the licensee takes the children to the park the licensee will sit at the bench and watch the children play, but sometimes she will walk back to the van and stand by the van.

Through the course of investigation, it was alleged that licensee pushed and threw children to the ground. C3 reported licensee grabbed another child (C5) by the cheeks, but C5 denied It happened. One child (C2) reported licensee grabbed their arm in a really hard way to talk to them and another child (C5) reported sometimes licensee will shake children and throw them on the ground but didn’t say who it happened to, or when it happened. These incidents were either not witnessed or could not be corroborated. One guardian (G5) reported licensee had put her hands on the back of her child to ‘scoot’ them to “ go, go, go”. Other guardian interviews (G1,G3,G4) reported they had not seen Licensee grab their children. Guardian G2 reported only other children had put their hands on their child.

G1 reported her child is a picky eater and would only eat the snacks the licensee offered. G2 reported she drops off her child hungry and licensee provides all the meals. G3 reported there was one occasion where her child was hungry after getting picked up from the day care. G5 corroborated that their child was hungry, and the licensee instructed them to look in their bag and eat the snack their guardian had packed. The prior two occasions LPA has been at the home the licensee’s staff has been preparing meals and feeding children.

Based on interviews conducted and records reviewed, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the allegation is Unsubstantiated. This report was reviewed and discussed with the licensee, She was provided with a copy of this CIR; and Appeal Rights. All licensing reports are public information and must be made available upon request for at least three years

This is an Amended report.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Elpidia Hernandez Torres
LICENSING EVALUATOR SIGNATURE:

DATE: 07/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/12/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5