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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483009866
Report Date: 11/23/2022
Date Signed: 11/23/2022 11:07:49 AM

Document Has Been Signed on 11/23/2022 11:07 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:AGUILAR, MIRANDA & AARON FCCHFACILITY NUMBER:
483009866
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 8CENSUS: 5DATE:
11/23/2022
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:36 AM
MET WITH:Miranda Aguilar - LicenseeTIME COMPLETED:
11:20 AM
NARRATIVE
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Licensing Program Analyst (LPA), Melchisedeck Augustin, conducted an unannounced Case Management visit to amend a prior report and deliver a citation to Licensee, Miranda Aguilar (LS). During the course of a complaint investigation, LPA Augustin, obtained evidence showing that LS violated children’s personal rights.

Multiple interviews described LS acting mean and/or rude at children and would become irritated or upset when children were doing things they weren’t supposed to be doing. Three statements (C1, C2, C5) confirmed that LS either grabbed children by the throat or choked them when something made LS upset. Two statements further indicated that on multiple occasions, LS tried to get the children's attention by using her hand or cell phone to tap the children when children were exhibiting undesirable behavior such as crying, jumping or touching something they weren’t allowed to touch. This type of discipline method is inconsistent with and does not comply with the requirements of personal rights of California Code of Regulations (CCR), 102423(a)(4).

Based on the evidence uncovered during the course of a complaint investigation, LS violated children’s personal rights resulting in the following citation of the California Code of Regulations, Title 22; Division 12, found on page two of the Facility Evaluation Report/LIC 809D.

Report was reviewed with LS and appeal rights were provided. A notice of site visit was given and must remain posted for 30 days along with the report and Type A citation. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. LS was also informed of the requirement to provide a copy of any licensing report that documents a Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/ guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 11/23/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/23/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/23/2022 11:07 AM - It Cannot Be Edited


Created By: Melchisedeck Augustin On 11/23/2022 at 09:53 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: AGUILAR, MIRANDA & AARON FCCH
FACILITY NUMBER: 483009866

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/23/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/24/2022
Section Cited
CCR
102423(a)(4)

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To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical
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Licensee stated she would research the definition of Personal Rights and review video clips on Personal Rights on the Department's transparency website, and Licensee intends to produced a written statement detailing how she plans to comply with CCR 102423(a)(4).
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functioning.

This requirement is not met as evidenced by: Based on three statements (C1, C2, C5) confirming LS either grabbed children by the throat or choked them when something made LS upset, and this poses/posed an immediate health, safety and/or personal rights risk to the children in care.
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The Licensee stated she would submit her written plan to the Department by 11/24/22 via mail, email or fax.

Email: melchisedeck.augustin@dss.ca.gov
Fax: 707-588-5099

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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.
SUPERVISOR'S NAME:Leslie Lepori
LICENSING EVALUATOR NAME:Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:
DATE: 11/23/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/23/2022


LIC809 (FAS) - (06/04)
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