483010069-9-9-2022-01-CC-AHON-CJ7VPY-20220912163731

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483010069
Report Date: 09/09/2022
Date Signed: 09/09/2022 01:51:52 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
07/06/2022 and conducted by Evaluator Yang Yang

PUBLIC

COMPLAINT CONTROL NUMBER: 01-CC-20220706095838

FACILITY NAME:	FELDER, REGINA		FACILITY NUMBER:	483010069
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 2	DATE:	09/09/2022
		UNANNOUNCED	TIME BEGAN:	12:07 PM
MET WITH:	Regina Felder		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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-Uncleared adults living or working in the family child care home
-Facility has mold

INVESTIGATION FINDINGS:

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An unannounced follow-up complaint investigation visit to the facility was made today by Licensing Program Analyst (LPA), Y. Yang to deliver complaint investigation findings. It was alleged that there are uncleared adults living or working at the Family Child Care Home (FCCH) and it was also alleged that there is mold present inside the home.

The LPA met with the facility’s licensee, Regina Felder (staff S1) today at 12:10pm discuss the investigation findings. A tour of the facility was conducted at 12:15pm today. There were two children present at the facility being supervised by one staff member. The initial investigation visit was made by the LPA on 07/07/22. During the initial investigation visit, the licensee denied the allegations and stated that all adults working or living at the FCCH have been fingerprint cleared and associated to the facility’s license. The licensee stated that there are five adults currently living at the home. The licensee stated that all employees or assistants at the FCCH are residents of the home. The licensee stated that she does not utilize any assistants or helpers from outside her home. The licensee stated that she understands that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to their initial presence in a licensed FCCH. (Continued on LIC 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

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-20220706095838

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: FELDER, REGINA	FACILITY NUMBER: 483010069
	VISIT DATE: 09/09/2022

NARRATIVE

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A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

During the investigation, interviews were conducted with adult residents/staff members S2-S5 on 07/07/22 and the childcare facility’s clients. Residents/staff members that were interviewed all corroborated the licensee’s statements and stated that there are only five adults working and living at this facility and all have been fingerprint cleared and associated to the facility. The clients that were interviewed all stated that they have not observed any adult that is not a resident of the home living or working at the FCCH. Furthermore, all individuals interviewed stated that they have not observed any mold or evidence of mold growth inside the home. Clients interviewed all complimented the licensee on the cleanliness of the facility.

During the LPA’s initial investigation visit to the facility and today’s follow up visit, the LPA toured the childcare areas of the home and did not observe any evidence or mold or water leaks inside the home. The home appeared to be clean and orderly. The LPA toured the facility and did not observe any evidence of other adults living in the home other than the licensee and four adult residents.

Based on the information gathered during this investigation, there is not a preponderance of evidence to support the allegations. The allegations are determined to be unsubstantiated. There were no Title 22 deficiencies cited. This report was reviewed and discussed with the facility’s licensee, Regina Felder. Appeal rights were provided. Notice of Site Visit shall be posted for 30 days from today's visit.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Yang Yang
LICENSING EVALUATOR SIGNATURE:	DATE: 09/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2022

LIC9099 (FAS) - (06/04)

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