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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 233010489
Report Date: 03/13/2024
Date Signed: 03/13/2024 01:52:22 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
02/21/2024 and conducted by Evaluator Robert Maciel
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240221141108
FACILITY NAME:SHANEL VALLEY ACADEMY EARLY LEARNING CENTERFACILITY NUMBER:
233010489
ADMINISTRATOR:JACINTO, LINDAFACILITY TYPE:
850
ADDRESS:1 RALPH BETTCHER DRIVETELEPHONE:
(707) 744-1485
CITY:HOPLANDSTATE: CAZIP CODE:
95449
CAPACITY:24CENSUS: 0DATE:
03/13/2024
UNANNOUNCEDTIME BEGAN:
09:09 AM
MET WITH:Kristi McculloughTIME COMPLETED:
10:06 AM
ALLEGATION(S):
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Staff restrained a child while in care
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Robert Maciel conducted an unannounced complaint visit, and met with Director Kristi Mccullough. It was alleged that a staff member restrained a child in care, specifically that on 11/16/23 and 2/14/24, C1 was restrained and prevented from leaving the bathroom. During today’s visit, the facility was toured, records were reviewed. Interviews with staff and adults conducted from 2/23/24 to 3/8/24 corroborate the allegation.

Based on the evidence obtained, the preponderance of evidence standard has been met; therefore, the above allegation is found to be substantiated. California Code of Regulations, Title 22, is being cited on the attached LIC 9099D. Appeal rights were provided.

Exit interview conducted, and report was reviewed with the Director Kristi Mccullough. 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.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
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-20240221141108
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: SHANEL VALLEY ACADEMY EARLY LEARNING CENTER
FACILITY NUMBER: 233010489
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/13/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/12/2024
Section Cited
CCR
101223(a)(6)
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The licensee shall ensure that each child is accorded the following personal rights:
Not to be locked in any room, building or center premises by day or night.
This requirement is not met as evidenced by:
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Director stated she would give staff training on personal rights using the CCLD provider instruction videos and a specialist from the Mendocino County Office of Education will come on 3/14/24 to observe, provide coaching for teachers,
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Based on interviews and record review, C1 was restrained in the preschool bathroom on 11/16/23 by A9 and on 2/14/24 by A8. This poses a potential health, safety and personal rights risk to children in care.
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and creating a quality improvement plan for the facility. Director stated she would send a copy of the quality improvement plan to LPA by email at robert.maciel@dss.ca.gov.
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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: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 03/13/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/13/2024
LIC9099 (FAS) - (06/04)
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