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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493010196
Report Date: 11/12/2024
Date Signed: 11/12/2024 09:39:09 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 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
08/15/2024 and conducted by Evaluator Melinda Mohr
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240815114612
FACILITY NAME:YWCA STARS PRESCHOOL-GUERNEVILLEFACILITY NUMBER:
493010196
ADMINISTRATOR:LAURIN JOHNSONFACILITY TYPE:
850
ADDRESS:14630 ARMSTRONG WOODS RD.TELEPHONE:
(707) 869-8106
CITY:GUERNEVILLESTATE: CAZIP CODE:
95446
CAPACITY:24CENSUS: 4DATE:
11/12/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Laurin JohnsonTIME COMPLETED:
08:40 AM
ALLEGATION(S):
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Staff did not comply with the admission agreement regulations
Staff did not follow facility's plan of operation
Staff violated child’s personal rights
Staff falsified documentation
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mindy Mohr made an unannounced complaint investigation visit today and met with Site Supervisor Laurin Johnson for the purpose of delivering findings for the following allegations. It was alleged staff did not comply with the admission agreement regulation, and staff did not follow facility’s plan of operation, specifically disenrolling a child in care as well as changing the monthly tuition. It was also alleged staff falsified documentation and staff violated a child’s personal rights by releasing a child’s confidential information.

LPA Mindy Mohr previously met with Site Supervisor Laurin Johnson on 08/21/2024 to open the complaint. A subsequent visit was made on 09/04/2024 to further investigate the complaint. During the course of the investigation, LPA Mohr conducted interviews and received documents pertaining to the investigation. From 08/16/2024 through 10/23/2024, interviews were conducted with Site Supervisor (S1), three staff (S2-S4) and five adults (A1-A5).
(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2024
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 2
Control Number 01-CC-20240815114612
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: YWCA STARS PRESCHOOL-GUERNEVILLE
FACILITY NUMBER: 493010196
VISIT DATE: 11/12/2024
NARRATIVE
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Staff (S1 & S2) denied the allegations stating all policies were followed. S1 specifically stated when a family changes their schedule, they are to contact River to Coast, the Resource and Referral Agency, to make the change to their schedule. River to Coast then contacts YWCA who then contacts the site to update the family’s agreement. Once the change has been made all parties sign the required contracts, including any rate change, which is reflected on the forms. S1 claimed to have witnessed parent of child (C1) sign all forms. In addition, S1 did admit to texting other individuals regarding C1, but stated she did not share confidential information. According to S2, C1’s schedule had been changed with River to Coast multiple times. River to Coast sent the contract to YWCA who then had the parent of C1 sign it. S2 further stated they had nothing to gain if someone forged a signature. S3 stated when a family makes a change to their schedule, they first request the change with staff at the site. The site supervisor then tells the administration at the office who then sends a certificate to River to Coast for approval. Once approved the schedule is changed and all parties sign the document. S3 also stated they do not think anyone would have forged the parent’s signature.

S1 – S4 all stated C1 was terminated due to reasons unrelated to the child’s care and supervision while in the facility. S3 stated it follows YWCA procedures. Documentation received during the investigation revealed the admission agreement and facilities plan of operation both provide written policies regarding termination and rate changes, however, there is no conclusive evidence to show if the parent’s signature had been forged on any documents.

Adult interview (A1) stated that the YWCA will change their rates and not let families know. A3 stated the YWCA is supposed to notify families at least 30 days prior to making a change, which they would not always do. A4 & A5 both stated they are unsure of the policy when it comes to rate or schedule changes but have not had any issues with their schedules. A4 also stated all the communication goes through an online application, which could make it possible for some communication to be lost. In addition, communication concerning C1 transpired between staff and individuals outside of the facility, however, there was no corroborating evidence to indicate it violated personal rights of the child.

Based on the information gathered during this investigation, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the allegation occurred and therefore is determined to be unsubstantiated. There were no Title 22 deficiencies cited. This report was reviewed and discussed with Site Supervisor, Laurin Johnson. Appeal rights were provided. Notice of Site Visit shall be posted for 30 days from today's visit. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melinda Mohr
LICENSING EVALUATOR SIGNATURE:

DATE: 11/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/12/2024
LIC9099 (FAS) - (06/04)
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