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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493010314
Report Date: 12/07/2023
Date Signed: 12/07/2023 01:36:33 PM

Substantiated


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
09/18/2023 and conducted by Evaluator Sebastian Phouthavong
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230918172202
FACILITY NAME:MT. TAYLOR CHILDREN'S CENTER THREEFACILITY NUMBER:
493010314
ADMINISTRATOR:ELHRS, JULIEFACILITY TYPE:
850
ADDRESS:812 VINEYARD CREEK DRIVETELEPHONE:
(707) 526-3008
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY:30CENSUS: 21DATE:
12/07/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Director, Karen Guerin & Varla DuraTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff failed to report incident to parent in a timely manner.
INVESTIGATION FINDINGS:
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A subsequent complaint investigation visit was conducted today by Licensing Program Analyst (LPA), Sebastian Phouthavong who met with Licensee, Varla Dura & Director, Karen Guerin for the purpose of delivering complaint investigation findings for the above allegation. LPA previously conducted an inspection on 09/21/2023 to initiate the investigation and met with Director, Karen Guerin to discuss the allegation, conduct interview(s), make observations, and request documents. It is alleged that Staff failed to report incident to parent in a timely manner, specifically that a child abstained an injury and the child’s authorized representative was not notified.

During the course of the investigation, LPA conducted interviews with the Director, 4 staff members (S1, S2 S4, S5), 4 children (C1-C4) & 5 Parents (P1-P5) from 09/21/2023 to 12/05/2023. D1 admitted that the child’s authorized representative was not notified of an injury in a timely manner but was notified that day. D1 stated the facility did not follow facility’s policies and procedures is to notify the authorized representatives of any incidents right away by phone call or text message.
(Continue on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
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-20230918172202
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: MT. TAYLOR CHILDREN'S CENTER THREE
FACILITY NUMBER: 493010314
VISIT DATE: 12/07/2023
NARRATIVE
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(Continued from LIC9099)
D1 further stated that staff have reviewed the reporting requirements to ensure the facility’s policy is being followed. Staff interviewed collaborated with D1’s statement. Parents and children’s interviews that were conducted did not reveal any concerns involving the allegation.

Based on the information gathered during this investigation, the preponderance of the evidence standard has been met. Therefore, the allegation is determined to be substantiated. California Code of Regulations, Title 22, is being cited on the attached LIC 9099-D. Appeal rights were provided. An exit interview was conducted, and this report was read and discussed with the facility’s Licensee, Varla Dura & Director, Karen Guerin. The Notice of Site Visit shall be posted for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
Control Number 01-CC-20230918172202
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: MT. TAYLOR CHILDREN'S CENTER THREE
FACILITY NUMBER: 493010314
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/07/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/08/2023
Section Cited
CCR
101173(b)(2)
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101173 Plan of Operation (b) The plan and related materials shall contain the following:
(2) Statement of admission policies and procedures. This requirement was not met as evidenced by:
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The facility has submitted a statement with staff signatures to ensure to notify parents of an incidents to LPA, Sebastian P. The POC has been cleared during the visit.
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Based on staff Interviews, the center failed to follow the center's policies and procedures and did not notify a parent of an incident in a timely matter. This poses a potential Health and Safety risk to children in care.
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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: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
09/18/2023 and conducted by Evaluator Sebastian Phouthavong
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230918172202

FACILITY NAME:MT. TAYLOR CHILDREN'S CENTER THREEFACILITY NUMBER:
493010314
ADMINISTRATOR:ELHRS, JULIEFACILITY TYPE:
850
ADDRESS:812 VINEYARD CREEK DRIVETELEPHONE:
(707) 526-3008
CITY:SANTA ROSASTATE: CAZIP CODE:
95403
CAPACITY:24CENSUS: 21DATE:
12/07/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Director, Karen Guerin & Varla DuraTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Staff yell at children in care.
Staff did not intervene with children having an altercation in a timely manner.
INVESTIGATION FINDINGS:
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A subsequent complaint investigation visit was conducted today by Licensing Program Analyst (LPA), Sebastian Phouthavong who met with Licensee, Varla Dura & Director, Karen Guerin for the purpose of delivering complaint investigation findings for the above allegations. LPA previously conducted an inspection on 09/21/2023 to initiate the investigation and met with Director, Karen Guerin to discuss the allegations, conduct interview(s), make observations, and request documents.

It is alleged that Staff yell at children in care, specifically that a staff member yelled at a child to sit down. Also, it was alleged that Staff did not intervene with children having an altercation in a timely manner, specifically that an incident involving 2 children occurred and a staff member did not intervene.

During the course of the investigation, LPA conducted interviews with the Director, 4 staff members (S1, S2 S4, S5), 4 children (C1-C4) & 5 Parents (P1-P5) from 09/21/2023 to 12/05/2023. D1 denied the allegations.
(Continued on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 01-CC-20230918172202
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: MT. TAYLOR CHILDREN'S CENTER THREE
FACILITY NUMBER: 493010314
VISIT DATE: 12/07/2023
NARRATIVE
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(Continued from LIC9099)
D1 and staff (S1, S2, S5) stated they do not yell at the children, but do raise their voices to get the children’s attention, with S1 and S5 stating that staff would use their, “Grumpy Voice.” S1 & S4 did claim there was a previous time that a staff member could be heard using a louder voice when frustrated. D1 stated that there was a recent staff meeting that provided proper ways to properly handle incidents involving children. Statements from staff (S2, S4, S5) stated if an incident involving 2 children occurred, they would immediately separate the children and use redirection. S1 and S2 stated they would calm the children down and if needed, S1 stated she would ask other staff for assistance. Parents and children’s interviews that were conducted did not reveal any concerns involving the allegation.

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 allegations occurred and therefore are determined to be unsubstantiated. There were no Title 22 deficiencies cited. This report was reviewed and discussed with the facility’s Licensee, Varla Dura & Director, Karen Guerin Appeal rights were provided. Notice of Site Visit shall be posted for 30 days from today's visit.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 12/07/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/07/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5