493008417-9-9-2021-01-CC-AHON-C6QTB2-20210910143420

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 493008417
Report Date: 09/09/2021
Date Signed: 09/09/2021 02:47:52 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/23/2021 and conducted by Evaluator Jennifer Velasco

COMPLAINT CONTROL NUMBER: 01-CC-20210623150232

FACILITY NAME:	ROSS, SHAELA FCCH		FACILITY NUMBER:	493008417
ADMINISTRATOR:	ROSS, SHAELA & ROBYN		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 483-9741
CITY:	SANTA ROSA	STATE: CA	ZIP CODE:	95405
CAPACITY:	14	CENSUS:	DATE:	09/09/2021
		UNANNOUNCED	TIME BEGAN:	01:10 PM
MET WITH:	Shaela Ross, Zen Robyn Ross		TIME COMPLETED:	02:40 PM

ALLEGATION(S):

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Licensee speaks inappropriately towards day care children

INVESTIGATION FINDINGS:

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An unannounced subsequent complaint investigation inspection was conducted by Licensing Program Analyst Jennifer Velasco (LPA), who met with licensee Shaela Ross (L1). It has been alleged that Licensee speaks inappropriately towards day care children; specifically, that when children approached L1, L1 spoke to them in a harsh tone. L1 denied the allegation and stated she speaks to children in a kind way. During the course of the investigation, LPA interviewed one witness (A1) on 06/24/2021. On 07/06/2021, LPA reviewed media, toured the facility, obtained facility documents, and interviewed three witnesses (L1, S1, C6). On 07/09/2021, LPA reviewed facility documents and media. On 07/12/2021, LPA toured the facility and interviewed one witness (C6). On 08/11/2021, LPA interviewed two witnesses (A3, A5). On 08/12/2021, LPA interviewed four witnesses (A6, C7, C8, S2). On 08/17/2021, LPA reviewed facility documents and media. Witness interviews and facility documents failed to corroborate the allegations.

Continued on LIC 9099-C.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20210623150232

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: ROSS, SHAELA FCCH	FACILITY NUMBER: 493008417
	VISIT DATE: 09/09/2021

NARRATIVE

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Continued from LIC 9099.

Although the allegation may have happened or is 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 during today's inspection. Appeal rights were provided. All licensing reports are public information and must be made available upon request for at least three years. This report was read and reviewed with L1, whose original signature is recorded on this report. Notice of Site Visit provided to L1 shall be posted for 30 days.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Jennifer Velasco
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2021

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2021

LIC9099 (FAS) - (06/04)

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