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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 483010798
Report Date: 11/05/2025
Date Signed: 11/05/2025 07:26:32 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC 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
11/03/2025 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20251103102227
FACILITY NAME:FAIRFIELD PRESCHOOL & CHILDCAREFACILITY NUMBER:
483010798
ADMINISTRATOR:OLDANI, SABRINAFACILITY TYPE:
860
ADDRESS:1004 UTAH STREETTELEPHONE:
(901) 240-7791
CITY:FAIRFIELDSTATE: CAZIP CODE:
94533
CAPACITY:44CENSUS: 6DATE:
11/05/2025
UNANNOUNCEDTIME BEGAN:
12:56 PM
MET WITH:Monika VermaTIME COMPLETED:
07:26 PM
ALLEGATION(S):
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Licensee does not ensure that staff has criminal clearance
INVESTIGATION FINDINGS:
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A complaint investigation inspection was conducted at the facility by Licensing Program Analysts (LPAs), Amy Strother and Jessica Gaumann. It has been alleged that Licensee does not ensure that staff has criminal clearance. LPA met with Licensee, Monika Verma (L1).

During today’s inspection LPAs were greeted by staff S1. During a tour of the facilty at 1:20pm L1 stated that on Monday, 11/03/25 she had a new staff (S2) here working for a few hours, stating she thinks she arrived between 9:00am and 10:00am and stayed until 12:00pm or 1:00pm. LPA Strother reviewed the facility roster, noting that S1 and S2 were not associated to the facility. L1 stated that she thought the former Director took care of it and that S2 was just here on a trial and told L1 that she had a clearance. LPAs verified with the Regional office that S1 has a criminal record clearance, eligible for transfer and worked with L1 to transfer S1's fingerprints to the facility during today's visit. LPAs verified that the transfer was complete and S1 is now currently associated to the facility.
Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
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 3
Control Number 01-CC-20251103102227
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA CC RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: FAIRFIELD PRESCHOOL & CHILDCARE
FACILITY NUMBER: 483010798
VISIT DATE: 11/05/2025
NARRATIVE
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Based on interview and record review the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Division 12 & Chapter 1), are being cited on the attached LIC9099D. A Civil Penalty in the amount of $600 was assessed. Appeal Rights were provided.

Exit interview conducted, and report was reviewed with Licensee, Monika Verma.

LPA Strother informed licensee Monika Verma that this report dated 11/05/25 document(s) one Type A citation Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA Strother informed the licensee to provide a copy of this licensing report dated 11/05/25 that documents any 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: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20251103102227
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: FAIRFIELD PRESCHOOL & CHILDCARE
FACILITY NUMBER: 483010798
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/06/2025
Section Cited
CCR
101170(e)(1)
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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department.

This requirement ws not met as evidenced by:
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During today's visit L1 completed a criminal background clearance transfer request form LIC9182, for S1, sending it to the Santa Rosa Regional office. S1 is now associated to the facility. L1 will submit a written procedure for hiring new staff, with steps to ensure each staff has an eligible clearance or exemption prior to working at the facility by 11/06/25.
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Based on interview and record review, two staff S1 and S2 were working with children at the facility without an associated criminal record clearance, which poses an immediate health & safety and personal rights risk to the children in care.
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Sending to LPA Strother's email: amy.strother@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: Melchisedeck Augustin
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 11/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3