<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493010083
Report Date: 05/01/2023
Date Signed: 05/01/2023 01:58:44 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
02/03/2023 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230203113758
FACILITY NAME:ACHIEVERSFACILITY NUMBER:
493010083
ADMINISTRATOR:HEATHER PETERSFACILITY TYPE:
850
ADDRESS:573 SUMMERFIELD ROADTELEPHONE:
(707) 539-6232
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY:90CENSUS: 35DATE:
05/01/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Heather PetersTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff inappropriately disciplined child
Unqualified staff providing care and supervision to children
Staff yelled at children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Amy Strother made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with Center Director, Heather Peters. It has been alleged that staff inappropriately disciplined child, unqualified staff provide care and supervision to children and that staff yelled at children.

During the initial investigation inspection on 02/09/23 LPA Strother toured the facility, received documents, reviewed video footage, and conducted interviews with Center Director (D1) and 6 staff Staff1 – Staff 6 (S1-S6). During the investigation, LPA Strother interviewed one adult, Adult 1 (A1) on 02/06/23.

Interviews with staff to include, D1 and S1 – S6 all stated that redirection is the main discipline style used, and that some version of “time-outs”, “sitting out” or “take a seat” is used when redirection to another activity does not work. S3 and S4 stated that they use a “calming corner” for children to take a break in addition to redirection.
Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
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 5
Control Number 01-CC-20230203113758
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: ACHIEVERS
FACILITY NUMBER: 493010083
VISIT DATE: 05/01/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
S3 and S6 stated that they will seek help from D1 when needed to address behavioral challenges that come up. LPA reviewed staff records on 02/09/23, specifically staff qualifications. LPA determined that S2-S6 are fully qualified teachers and S1 is currently qualified as an aide. D1 denied that unqualified staff are providing care and supervision. Interviews with S1-S6 indicate that S1 is never left alone with children, stating that when the fully qualified teacher that S1 supports is not present, S1’s group of children are either combined with another group of children with two or more fully qualified staff or D1 steps in to provide care and supervision to the children with S1. Interviews with staff to include, D1 and S1 – S6 all denied the allegation that staff yell at children. Five out of seven staff interviewed stated that they have heard “firm”, “sharp” or “stern” tones of voice used by staff in instances that concerned safety, but have never heard yelling.
Based on available information, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations occurred, therefore, the allegations are UNSUBSTANTIATED.

Notice of Site Visit shall be posted for 30 days from today's visit. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

This report was reviewed and discussed with Center Director, Heather Peters.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5
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
02/03/2023 and conducted by Evaluator Amy Strother
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230203113758

FACILITY NAME:ACHIEVERSFACILITY NUMBER:
493010083
ADMINISTRATOR:HEATHER PETERSFACILITY TYPE:
850
ADDRESS:573 SUMMERFIELD ROADTELEPHONE:
(707) 539-6232
CITY:SANTA ROSASTATE: CAZIP CODE:
95405
CAPACITY:90CENSUS: 35DATE:
05/01/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Heather PetersTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not adequately supervise children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA), Amy Strother made a subsequent complaint investigation inspection, for the purpose of delivering complaint findings, and met with Center Director, Heather Peters. It has been alleged that staff do not adequately supervise children in care, specifically that child (C2) was left outside unsupervised for 15 minutes.

During the initial investigation inspection on 02/09/23 LPA Strother toured the facility, received documents, reviewed video footage, and conducted interviews with Center Director (D1) and 6 staff Staff 1 – Staff 6 (S1-S6). During the investigation, LPA Strother interviewed one adult, Adult 1 (A1) on 02/06/23.

Based on review of video footage, dated 01/17/23 and staff interviews, there is a preponderance of evidence to show there was absence of supervision which resulted in C2 being left without staff supervision on the play yard from 4:23pm to 4:40pm (17 minutes). C2 was let back inside, after a parent discovered C2 from the other side of the fence and alerted staff, therefore the allegation is substantiated.
Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 01-CC-20230203113758
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: ACHIEVERS
FACILITY NUMBER: 493010083
VISIT DATE: 05/01/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The facility did not comply with Health and Safety Code (H&S), 1596.99(c)(3) and an immediate Civil Penalty of $500 is being assessed for absence of supervision. The following Health and Safety Code, Title 22, Division 6, Chapter 3.5 violation is being cited on the following LIC 9099D.

Exit interview conducted, and report was reviewed with the Center Director, Heather Peters.

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.

LPA Strother informed facility representative, Heather Peters that this report dated 05/01/23 documents one Type A citation which shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Strother informed Heather Peters to provide a copy of this licensing report dated 05/01/23 that documents a Type A citation 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: Alexis Hollon
LICENSING EVALUATOR NAME: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 01-CC-20230203113758
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: ACHIEVERS
FACILITY NUMBER: 493010083
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/01/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/02/2023
Section Cited
HSC
1596.99(c)(3)
1
2
3
4
5
6
7
The department shall assess an immediate civil penalty of five hundred dollars ($500) per violation and one hundred dollars ($100) for each day the violation continues after citation, for any of the following serious violations: Absence of supervision, including, but not limited to, a child left unattended…
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Center Director (D1) stated she would submit a written plan to the Department by 05/02/23 detailing the steps she has already implemented to comply with supervision requirements,
8
9
10
11
12
13
14
Based on interviews and record review C2 was left without staff supervision on the play yard for 17 minutes on 01/17/23, which posed an immediate health, safety and/or personal rights risk to the child in care.
8
9
10
11
12
13
14
including the staff training/content discussion from the the all staff meeting that was held on 02/06/23, signed by all staff.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Amy Strother
LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5