<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493005113
Report Date: 05/11/2022
Date Signed: 05/11/2022 02:14:27 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
03/14/2022 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20220314135641
FACILITY NAME:PINE TREE SCHOOL LLC - PRESCHOOLFACILITY NUMBER:
493005113
ADMINISTRATOR:SOTO, ESMERALDAFACILITY TYPE:
850
ADDRESS:20 ADELINE WAYTELEPHONE:
(707) 433-8447
CITY:HEALDSBURGSTATE: CAZIP CODE:
95448
CAPACITY:50CENSUS: 46DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
12:18 PM
MET WITH:Mindy MeronekTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not provide a safe and healthful environment for day care children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
A subsequent complaint investigation inspection was conducted at the facility by Licensing Program Analyst (LPA), Amy Strother to deliver complaint investigation findings. It has been alleged that staff do not provide a safe and healthful environment for day care children, specifically that the cleaning products used to clean the facility smell so strong that the children go home smelling of cleaning products.
LPA met with facility representative, Mindy Meronek. An initial investigation visit was made by the LPA on 03/21/22. During the visit on 03/21/22, LPA requested and received a copy of the facility roster, personnel report and designation of facility responsibility form LIC308. During the compliant investigation, LPA toured the facility including a tour of the cleaning product storage area and products used to the clean the facility. LPA noted that the label on the cleaning product used to clean the classroom floors states to mix ΒΌ cup in a gallon of water, no rising required. On 03/21/22 LPA conducted interviews with five staff, Staff 1 – Staff 5 (S1-S5) beginning at 9:58am.
Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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 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
03/14/2022 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20220314135641

FACILITY NAME:PINE TREE SCHOOL LLC - PRESCHOOLFACILITY NUMBER:
493005113
ADMINISTRATOR:SOTO, ESMERALDAFACILITY TYPE:
850
ADDRESS:20 ADELINE WAYTELEPHONE:
(707) 433-8447
CITY:HEALDSBURGSTATE: CAZIP CODE:
95448
CAPACITY:50CENSUS: 46DATE:
05/11/2022
UNANNOUNCEDTIME BEGAN:
12:18 PM
MET WITH:Mindy MeronekTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff exposed daycare children to cleaning products
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
A subsequent complaint investigation inspection was conducted at the facility by Licensing Program Analyst (LPA), Amy Strother to deliver complaint investigation findings. It has been alleged that staff exposed daycare children to cleaning products, specifically that cleaning is conducted in the presence of children and children are breathing in cleaning products all day.
LPA met with facility representative, Mindy Meronek. An initial investigation visit was made by the LPA on 03/21/22. During the visit on 03/21/22, LPA requested and received a copy of the facility roster, personnel report and designation of facility responsibility form LIC308. During the compliant investigation, LPA toured the facility including a tour of the cleaning product storage area and products used to the clean the facility. On 03/21/22 LPA conducted interviews with five staff, Staff 1 – Staff 5 (S1-S5) beginning at 9:58am.

Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
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 01-CC-20220314135641
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: PINE TREE SCHOOL LLC - PRESCHOOL
FACILITY NUMBER: 493005113
VISIT DATE: 05/11/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
During the interview, S1 stated that she cleans the floor of the lunch room while the children are sleeping in a neighboring room, separate from where she is using cleaning products and that she opens the window while cleaning. S3 stated that the floors are cleaned when the children are outside playing or after they are closed and that she keeps the windows open and the fan on for circulation of the air. S4 stated that the floors are cleaned when all of the kids are outside at about 4:30 for the Preschool and then cleans the toddler room at about 5:20pm, closing the windows after she is finished cleaning. S5 stated that she cleans the floor of the meal/activity room at nap time because the children use the neighboring room during nap and are not in the room and the floor is mopped again, later in the day at about 4pm or 5pm when the children are outside and that she opens the windows all of the time, and also when she mops the floor.

Interviews with S1 and S3-S5 corroborated that staff do not expose the daycare children to cleaning products, and that cleaning is conducted when children are sleeping in neighboring classrooms separate from the room that is being cleaned or while children are outside and that windows are open while cleaning.

Based on available information, interviews conducted, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is unsubstantiated.
There were no Title 22 deficiencies cited for this allegation.

Exit interview conducted and report was reviewed with facility representative, Mindy Meronek. Appeal rights were provided

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 01-CC-20220314135641
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: PINE TREE SCHOOL LLC - PRESCHOOL
FACILITY NUMBER: 493005113
VISIT DATE: 05/11/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
During the interview, S1 stated that the floor cleaner used is Fabuloso – Purple, that she cleans the floor of the lunch room while the children are sleeping in a neighboring room, separate from where she is using the product, that she opens the window while cleaning and that she does not measure the amount of cleaner used. S3 stated that to clean the floors she uses a cleaner called Fabuloso and some bleach; with the bucket about half filled with water, she adds about a cup of Fabuloso and just a couple drops of bleach. The Fabuloso mix is used on the floors when the children are outside playing or after we are closed and that she keeps the windows open and the fan on for circulation of the air. S4 stated when she makes the mop cleaner for the classrooms, she uses bleach, Fabuloso, and a little soap, giving the example, if the bucket is filled halfway with water, she puts a lot of Fabuloso, just pouring it in, not measuring it, a cap of bleach and then 4 or 5 drops of soap, using the mop to mix it up. S4 further stated that the Fabuloso mix is used when all of the kids are outside at about 4:30 for the Preschool and then cleans the toddler room at about 5:20pm. S5 stated that she cleans the floor of the meal/activity room at nap time because the children use the neighboring room during nap and are not in the room, that she uses Fabuloso and water, filling the bucket 3/4 full of water and then pours in some Fabuloso, without measuring it. S5 stated the floor is mopped again, later in the day at about 4 or 5pm when the children are outside and that she opens the windows all of the time, and also when she mops the floor.

Interviews with S1 and S3-S5 corroborated that staff do not measure the cleaner used for cleaning the floors and use differing amounts of water in the bucket, some adding bleach and/or soap to the cleaner and water.

Based on evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. The following violation of the California Code of Regulations, Title 22: Division 12, was observed: See LIC9099D. Appeal Rights were provided.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with facility representative, Mindy Meronek. LPA provided the facility with the following handouts from the California Department of Pesticide Regulation: "Disinfectants & Surface Sanitizers in Schools and Child Care Programs", A poster titled "Never mix bleach with other cleaners" in English and Spanish and a poster titled "Bleach and soap don't mix!"
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20220314135641
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: PINE TREE SCHOOL LLC - PRESCHOOL
FACILITY NUMBER: 493005113
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/11/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/12/2022
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Facility Representative, Mindy Meronek stated that she has trained all staff on how to measure the bleach and water solution used to clean surfaces and the amount of Fabuloso cleaner to be used per gallon of water, which is 1/4 cup, as stated on the label for cleaning floors and posted directions in the cleaning storage closet.
8
9
10
11
12
13
14
Based on interviews and LPA observations, the licensee did not ensure that staff were following the label directions on the cleaner used to clean the classroom floors. On more than one occasion, each staff used a different cleaner to water ratio and some added bleach and/or soap to the cleaner mix, which poses a potential health, safety and personal rights risk to the children in care.
8
9
10
11
12
13
14
LPA verified and documented the posted instructions on preparing products for cleaning during the visit, and obtained signed verification of staff training from staff present during the visit, clearing the citation.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/11/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/11/2022
LIC9099 (FAS) - (06/04)
Page: 5 of 5