483008850-12-15-2023-01-CC-LLEI-CYPTPY-20231220135504

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483008850
Report Date: 12/15/2023
Date Signed: 12/15/2023 01:18:53 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, 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
09/22/2023 and conducted by Evaluator Melchisedeck Augustin

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20230922144249

FACILITY NAME:	ROERDEN, ALLISON FAMILY CHILD CARE HOME		FACILITY NUMBER:	483008850
ADMINISTRATOR:	ROERDEN, ALLISON		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 718-7505
CITY:	VACAVILLE	STATE: CA	ZIP CODE:	95687
CAPACITY:	14	CENSUS: 11	DATE:	12/15/2023
		UNANNOUNCED	TIME BEGAN:	11:40 AM
MET WITH:	Allison Roerden - Licensee		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Licensee did not provide adequate supervision resulting child sustaining injury while in care.
Licensee allowed unauthorized adult to pick up daycare children.
Licensee did not provide adequate supervision resulting daycare child obtaining hazardous object.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Melchisedeck Augustin made an unannounced subsequent Complaint-Investigation visit and met with the Licensee (LS), Allison Roerden, for the purpose of delivering findings for the above allegations. It is alleged that the Licensee did not provide adequate supervision resulting in a child sustaining injury while in care and the Licensee did not provide adequate supervision resulting in daycare child obtaining hazardous object. It is also alleged that the Licensee allowed unauthorized adult to pick up daycare children. The report noted an unsupervised child (C1) dropped a brick on their foot, resulting in a broken toe, C1 obtained scissors and cut their own hair, and on two separate occasions; LS released children (C1 & C2) to a person (A4) that was not on the authorized pickup list.

This complaint was referred to the Department’s Investigations Branch (IB), which was accepted as an assignment, resulting in IB Investigator, Jeff LaGrange interviewing one adult (A3) on 09/29/23.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

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-20230922144249

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ROERDEN, ALLISON FAMILY CHILD CARE HOME	FACILITY NUMBER: 483008850
	VISIT DATE: 12/15/2023

NARRATIVE

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Starting from 09/29/23 through 11/27/23, LPA met with LS and Facility Representative to initiate the complaint by discussing the purpose of the visit, obtained a facility roster of the children in care, made observations, interviewed LS and two staff (S1-S2), three children (C3 & C5-C6), three adults (A1-A2 & A4), and six parents (P1-P6). Some children were not verbal, too young to interview, unavailable for interview or did not qualify to be interviewed. LS denied claims about C1 obtaining hazardous object(s) and/or dropping a brick and sustained a broken toe as a result of inadequate supervision, and LS stated that no child(ren) was ever left unattended, and the only injury LS recalled witnessing while LS and another staff were supervising the children in the backyard, occurred in August or September 2021, where C1 tried to pull or lean over stacks of bricks which caused a brick to land on C1’s foot; resulting in C1 sustaining a bloody right toe. LS noted the toe was bloody but not broken, and C1 did not lose a toenail; and LS notified C1’s parent/guardian of the incident.

Furthermore, LS did not recall any incident(s) involving any child(ren) grabbing scissors and cutting their hair. LS claimed A4 never picked up the children without being accompanied by the children’s authorized representative (A2), and LS confirmed on one occasion when A4 came alone to the door to pick up C1 & C2, LS felt comfortable releasing the children because LS poked her head outside her door and saw A2 sitting in a vehicle and talking on the phone. Although A4 was not on the authorized pickup list, there are indications to suggest LS was familiar with A4 because A4 always accompanied A2 during pickup times. When children started to gather in areas with poor visibility, staff moved to those areas to ensure adequate supervision of the children.

Statements provided by S1-S2 indicated they were not present when C1 injured the right toe, they did not have any knowledge related to the injury and did not know if A4 was on the authorized pickup list. The staff did not report any recent or prior incident(s) related to children sustaining injury or concerns related to lack of staffing and/or lack of supervision. Staff said that on occasions, they sometimes ran inside to grab a child’s shoe and the children were left alone in the yard for a brief period, and furthermore; staff did not have any recollection of children being left without staff supervision. Staff confirmed that several sections of the yard including the sides of the home and behind a red shed had poor visibility, and staff positioned themselves in certain areas to gain better visibility. (Continue to LIC 9099-C)

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20230922144249

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: ROERDEN, ALLISON FAMILY CHILD CARE HOME	FACILITY NUMBER: 483008850
	VISIT DATE: 12/15/2023

NARRATIVE

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Statements provided by children, A1-A4, and P1-P6 did not report concerns related to children sustaining injuries because of lack of or absence of supervision, or children gaining access to hazardous items, and some statements claimed they either did not have any knowledge of the incident, denied C1’s toe had broken or had knowledge of the injury but denied that C1 sustained a broken bone; as well as A2 & A4 corroborated LS’s statement which claimed A4 always accompanied A2 during pick up times. It is also noted that one witness alleged seeing children left alone in the backyard for up to ten minutes. During LPA’s visits to the facility on 09/29/23 and 11/20/23, LPA did not see any child(ren) left unattended and saw staff actively supervising the children during indoor and outdoor activities, the hazards and compounds were inaccessible; and there were no health or safety concerns noted.

Based on the investigation, there was no conclusive evidence to support the allegations. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are unsubstantiated. 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. There were no violation(s) of California Code of Regulations, Title 22, Division 12 cited at this time. Appeal Rights were provided.

SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2023

LIC9099 (FAS) - (06/04)

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