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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483010165
Report Date: 09/23/2022
Date Signed: 09/23/2022 02:20:27 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
07/27/2022 and conducted by Evaluator Melchisedeck Augustin
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20220727094418
FACILITY NAME:PERKINS, JOYCE FCCHFACILITY NUMBER:
483010165
ADMINISTRATOR:PERKINS, JOYCEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 655-0922
CITY:VALLEJOSTATE: CAZIP CODE:
94590
CAPACITY:14CENSUS: 1DATE:
09/23/2022
UNANNOUNCEDTIME BEGAN:
11:55 AM
MET WITH:Joyce Perkins - Licensee TIME COMPLETED:
02:30 PM
ALLEGATION(S):
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Licensee did not provide supervision to children in care
Licensee did not provide an appropriate place for infant to sleep
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Melchisedeck Augustin conducted an unannounced subsequent complaint-Investigation visit and met with Licensee, Joyce Perkins (LS) to deliver the finding regarding the above allegations. LPA previously met with LS on 08/03/22 to initiate the investigation by discussing the purpose of the visit, requesting a facility roster of the children currently in care, and making observations. It was alleged that the Licensee did not provide supervision to children in care and Licensee did not provide an appropriate place for infant to sleep.

From 08/03/22 through 09/06/22, LPA Augustin interviewed LS, six children, one adult (A1), and two staff (S1 & S2). Some children were not verbal, too young to interview, or did not qualify to be interviewed. LS’s statement confirmed she did not provide a place for infant to sleep as required by regulation when she stated all children enrolled in care, including infant(s) who was/were unable to climb out of a play yard or crib, napped on a cot or mat that was covered with a blanket on the living room floor. (Continue to LIC 9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
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 4
Control Number 01-CC-20220727094418
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: PERKINS, JOYCE FCCH
FACILITY NUMBER: 483010165
VISIT DATE: 09/23/2022
NARRATIVE
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LS stated she did not have a crib or play yard available for infant(s) that met the United States Consumer Product Safety Commission (CPSC) safety standards, and LS was unaware of the Infant Safe Sleep requirements. Furthermore, LS denied claims about not providing supervision to the children in care and stated that when the children were in care, she was in the living room providing supervision to the children. LS also asserted she had not left children unattended.

According to interviews, multiple statements confirmed that the children, which included infant(s), napped on a rectangular shaped mat in the living room while on occasion LS stayed in her own room for an extended period of time resulting in younger children being left alone in the living room under the care of other older minor children in care. In addition, W4, W5 & W6 indicated on more than one occasion, LS left several daycare children unattended in her parked vehicle while LS stopped at and went inside various fast food restaurants to pick up food during their trip to the local public community park(s). Some of these occasions, the older minor children were asked to watch over the younger children resulting in an absence of the supervision. S1 confirmed she did not accompany LS and the children on their trips to the park or when they stopped to pick up food at various restaurant, while, S2 stated she was not present for every trip.

Based on the investigation, there’s a preponderance of evidence to show LS did not provide an appropriate place for infant to sleep and LS did not provide the required supervision to children in care resulting in an absence of supervision. Therefore, the allegations are substantiated, and an immediate $500 Civil Penalty is being assessed for absence of supervision. The California Code of Regulations, Title 22, Division 12, Chapter 1 is being cited on the attached LIC 9099D. Appeal Rights were provided and exit interview conducted.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 01-CC-20220727094418
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: PERKINS, JOYCE FCCH
FACILITY NUMBER: 483010165
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/24/2022
Section Cited
HSC
1596.99(c)(3)
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Absence of supervision, including, but not limited to, a child left unattended, and supervision of a child by a person under 18 years of age.

This requirement is not met as evidenced by:
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The Licensee produced and provided a written statement to LPA which detailed how she intends to comply with supervision requirements of Health and Safety Code, 1596.99(c)(3).
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Based on statements provided by several witnesses which corroborated LS left several daycare children unattended in her parked vehicle while LS stopped at and went inside various fast food restaurants to pick up food during their trip to the park(s). This posed an immediate health, safety and personal rights risk to the children in care.
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Email: melchisedeck.augustin@dss.ca.gov
Fax: 707-588-5099
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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: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 01-CC-20220727094418
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: PERKINS, JOYCE FCCH
FACILITY NUMBER: 483010165
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/30/2022
Section Cited
CCR
102425(a)
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There shall be one crib or play yard for each infant who is unable to climb out of the crib or play yard.

This requirement is not met as evidenced by: Based on multiple statements confirming that children, which included infant(s) that were
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The Licensee purcahsed a new crib which met the United States Consumer Product Safety Commision (CPSC) standards for infant(s) that are unable to climb out out of a play yard or crib to nap in. The Licensee also produced and submitted a written statement outlining how she intends to comply with Infant Safe Sleep requirements.
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unable to climb out of a crib or play yard, napped on a rectangular shaped mat in the living room. This posed a health, safety and/or personal rights risk to the children in care.
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Email: melchisedeck.augustin@dss.ca.gov
Fax: 707-588-5099
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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: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4