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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 173010115
Report Date: 08/17/2023
Date Signed: 08/17/2023 10:12:44 AM

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
05/08/2023 and conducted by Evaluator Sebastian Phouthavong
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230508082622
FACILITY NAME:CORDERO MARROQUIN, HERLINDA FCCHFACILITY NUMBER:
173010115
ADMINISTRATOR:CORDERO MARROQUIN,HERLINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 375-1701
CITY:KELSEYVILLESTATE: CAZIP CODE:
95451
CAPACITY:14CENSUS: 7DATE:
08/17/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Herlinda Cordero MarroquinTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Staff did not ensure child was not bullied by other day care children
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Sebastian Phouthavong, conducted a subsequent complaint investigation inspection on 08/17/2023 at 09:00AM for the purpose of delivering the findings regarding the above allegation. LPA Elpidia Hernandez Torres previously met with Licensee on 05/15/2023 to discuss the purpose of the visit, conduct interviews, and request children roster. It was alleged that staff did not ensure child was not bullied by other day care children.

During the course of the investigation, interviews were conducted with licensee, assistant, and five children (C1-C5) between 05/12 and 05/15. On 05/15/2023, licensee reported there was an incident where a guardian arrived to pick up a child, when the other children were playing a princess game and C3 called C1 a ‘Fat princess’. Licensee spoke with C3’s guardian about the incident and the guardian agreed to talk to C3 about it. All children interviews corroborated they have been bullied while at the daycare by varies children. One child reported they were called ‘fatty’, by another child, and some children say mean things quietly so the licensee doesn’t hear.
(Continue on LIC9099-C)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
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-20230508082622
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: CORDERO MARROQUIN, HERLINDA FCCH
FACILITY NUMBER: 173010115
VISIT DATE: 08/17/2023
NARRATIVE
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(Continue from LIC9099)
Another interview revealed, they are called dumb by another child. Another child reported they were hit in the belly and hit in the butt by another child. Another child (C5) reported a child always asks them “is that your poo poo or pee pee”, and that the child is always breaking down the blocks C5 has built. C1 reported the younger children listen to the older children and the older children tell the younger children to do mean things such as break down other children’s blocks. All children’s interviews revealed the licensee tells the children who are being mean, they are not listening and to stop.
Based on interviews conducted the preponderance of evidence standard has been met and the above allegation is found to be substantiated. The California Code of Regulations, Title 22, Division 12 & Chapter 1, section 102423(a)(1) is being cited on attached LIC 9099D . This report was reviewed with the Licensee and an exit interview was conducted. Licensee’s signature was recorded on this Complaint Investigation Report (CIR), a copy was provided. Notice of Site Visit shall be posted for 30 days. Appeal Rights were provided.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 01-CC-20230508082622
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: CORDERO MARROQUIN, HERLINDA FCCH
FACILITY NUMBER: 173010115
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/01/2023
Section Cited
CCR
102423(a)(1)
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102423(a)(1) Personal Rights: Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged. . .These rights include. . . To be treated with dignity in his/her personal relationship with staff and other persons.
This was not met as evidence by. . .
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Licensee agrees to submit a written plan on how she will prevent and mitigate bullying. She will email, mail or fax the plan to LPA Hernandez Torres on or before 09/01/2023.
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Based on interviews, licensee did not prevent some children from teasing, and bullying other children while in care. 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: 08/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 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
05/08/2023 and conducted by Evaluator Sebastian Phouthavong
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230508082622

FACILITY NAME:CORDERO MARROQUIN, HERLINDA FCCHFACILITY NUMBER:
173010115
ADMINISTRATOR:CORDERO MARROQUIN,HERLINDAFACILITY TYPE:
810
ADDRESS:5553 VISTA DRIVETELEPHONE:
(415) 375-1701
CITY:KELSEYVILLESTATE: CAZIP CODE:
95451
CAPACITY:14CENSUS: 7DATE:
08/17/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Herlinda Cordero MarroquinTIME COMPLETED:
10:15 AM
ALLEGATION(S):
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Due to lack of supervision, day care child inappropriately touched another child
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Sebastian Phouthavong conducted a subsequent complaint investigation visit with licensee for the purpose of delivering complaint investigation findings. It has been alleged due to lack of supervision; day care child inappropriately touched another child.

During the initial investigation interviews were conducted with licensee, assistant, and five children (C1-C5). On 05/15/2023, licensee reported some time last year one child (C1) had reported to her that another child (C3) had pulled C1’s pants down. Licensee reported the incident allegedly occurred on a Friday, but that it had not occurred since the licensee sat in between C1 and C3 on that day. Assistant reported, there was one occasion where she observed C1 attempting to pull down C3’s pants while playing, then C1 stopped and went to their mom. Some children reported other children have pulled their pants down, but the licensee will talk to those children. One interview revealed C3 was tickling them, and they didn’t like it, so Licensee placed C3 on time out. Another interview revealed while children were playing in the play structure C3 was attempting to touch the children when Licensee told C3 not to touch the children.
(Continue on LIC9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20230508082622
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: CORDERO MARROQUIN, HERLINDA FCCH
FACILITY NUMBER: 173010115
VISIT DATE: 08/17/2023
NARRATIVE
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(Continue from LIC9099)
Two guardians were interviewed between 05/17 and 08/10. One interview revealed there was an issue with the children at school where they were smacking each other’s butts but couldn’t remember if it was happening at the daycare. Guardian interviews corroborated they don’t believe there is a lack of supervision at the daycare.

Based on interviews conducted although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation occurred, therefore the allegation is Unsubstantiated. This report was reviewed and discussed with the licensee, She was provided with a copy of this CIR; and Appeal Rights. All licensing reports are public information and must be made available upon request for at least three years.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5