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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483010114
Report Date: 02/28/2024
Date Signed: 02/28/2024 01:26:32 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-20240221091755
FACILITY NAME:CIRCLE OF FRIENDS CHILD DEVELOPMENT CENTERFACILITY NUMBER:
483010114
ADMINISTRATOR:TANYA MCKNEELYFACILITY TYPE:
850
ADDRESS:3045 ROCKVILLE ROADTELEPHONE:
(707) 425-2717
CITY:FAIRFIELDSTATE: CAZIP CODE:
94534
CAPACITY:99CENSUS: 29DATE:
02/28/2024
UNANNOUNCEDTIME BEGAN:
09:21 AM
MET WITH:Farm SaeleeTIME COMPLETED:
01:35 PM
ALLEGATION(S):
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Staff inappropriately disciplines child in care.

Staff yelled at a child in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Robert Maciel conducted an unannounced complaint visit, and met with Facility Representative Farm Saelee. It was alleged that a staff member grabbed a child by the arm and forced them into a chair and yelled at them. Interviews with adults and staff and observations made at the facility corroborate the allegations. During today’s visit facility was toured and records were reviewed. LPA observed security camera footage of the incident and obtained a statement written by the director.

Based on the evidence obtained, the preponderance of evidence standard has been met; therefore, the above allegations are 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 Facility Representative Farm Saelee. 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: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
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-20240221091755
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: CIRCLE OF FRIENDS CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 483010114
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/28/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/27/2024
Section Cited
CCR
101223(a)(1)
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To be accorded dignity in his/her personal relationships with staff and other persons.

This requirement is not met as evidenced by:
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S2 has read and signed the LIC 613A Personal Rights form, watched the CDSS Children's Personal Rights in Child Care video and signed a written statement of acknowledgement and understanding of the facility policy of protecting a child's personal rights.
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Based on observations and interviews, C1 was grabbed by the arm and placed onto a chair and was yelled at by S3. This poses a potential health, safety and personal rights risk to the 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: Alexis Hollon
LICENSING EVALUATOR NAME: Robert Maciel
LICENSING EVALUATOR SIGNATURE:

DATE: 02/28/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2