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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493010084
Report Date: 11/17/2023
Date Signed: 11/19/2023 10:28:29 PM

Substantiated


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
03/16/2023 and conducted by Evaluator Leticia Rosales
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230316124635
FACILITY NAME:MUNOZ ARREOLA, CARMENFACILITY NUMBER:
493010084
ADMINISTRATOR:MUNOZ ARREOLA, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 889-1056
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:14CENSUS: 13DATE:
11/17/2023
UNANNOUNCEDTIME BEGAN:
02:00 AM
MET WITH:Maria Medina and Migdalia DiazTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Licensee did not provide sufficient supervision to prevent a day care child from leaving the facility.

Licensee does not ensure the backyard is safe and free of hazards for day care children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Leticia Rosales-Meza conducted an unannounced follow-up complaint inspection to the facility for the purpose of delivering complaint findings, and met with licensee's assistants, Maria Medina and Migdalia Diaz. It has been alleged that the licensee did not provide sufficient supervision to prevent a day care child from leaving the facility, specifically, on 3/15/23, two year old Child 1 (C1) left the facility without the licensee and or her assistant’s knowledge. On 3/15/23 at 5:53pm the licensee self-reported the incident. On 5/19/2023 LPA Laura Chavez conducted an interview between 1:23pm - 2:12pm with Licensee Carmen Munoz who stated the side door was left open at approximately 4:45pm allowing C1 to leave the facility without her knowledge. On 11/07/23 LPA Laura Chavez conducted an interview between 3:21pm – 3:29pm with Adult 1 (A1), who stated that on 3/15/2023 at approximately 4:30pm A1 found C1 walking on A1’s driveway as A1 pulled up, almost running C1 over with A1’s car. A1 stated A1 walked to the nearby park asking everyone A1 saw if C1 belonged to them, and after approximately 15 minutes of not locating C1’s parents A1 called 911. Santa Rosa Police Department Call for Service log from 3/15/23 was reviewed and call was received at 5:10pm. Interviews and record review indicate that on 3/15/23 C1 was without supervision for at least 10 minutes and had wandered approximately 110 feet from the facility before being found by A1.

Continue on LIC9099-C
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
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 6
Control Number 01-CC-20230316124635
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: MUNOZ ARREOLA, CARMEN
FACILITY NUMBER: 493010084
VISIT DATE: 11/17/2023
NARRATIVE
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It was also alleged that the Licensee does not ensure the backyard is safe and free of hazards for day care children. On 3/23/23, LPA Yang Yang observed in the backyard, and took photographs and video of, a canvas shade structure that had fallen over and lying on its side, a two foot long metal landscaping stake lying on the ground, two Pac ‘n Plays that were heavily damaged and strewn about the outdoor play area and the fence located on the right side of the outdoor play area was partially leaning toward the neighbor's yard. LPA Yang Yang instructed Staff 1 (S1) to remove the metal stake. LPA Yang Yang also observed in the front yard, a wine barrel partially filled with water and LPA Yang Yang instructed S1 to dump out the water. Photographs taken on 3/23/23 by LPA Yang also show a heating and/or air conditioning unit located in the outdoor play area with exposed wires.

Based on information obtained from interviews, record review and observations during the investigation, the preponderance of evidence standard has been met; therefore, the above allegations are found to be substantiated. California Code of Regulations, Title 22 are being cited on the attached LIC 9099-D. Civil penalties apply.

An exit interview was conducted, and this report was read and discussed with licensee's Staff Maria Medina and Migdalia Diaz. Appeal Rights and a Notice of Site Visit were given. The Notice of Site Visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

LPA Rosales-Meza informed Staff, Maria Medina and Migdalia Diaz that this report dated 11/17/23 documents 3 Type A citations 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 Rosales-Meza informed Staff, Maria Medina and Migdalia Diaz to provide a copy of this licensing report dated 11/17/23 that documents any Type A citations 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. An Acknowledgement of Receipt of Licensing Reports LIC 9224 form must be completed and signed by each parent/guardian and placed in each child's file for verification.

SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 6
Control Number 01-CC-20230316124635
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: MUNOZ ARREOLA, CARMEN
FACILITY NUMBER: 493010084
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/17/2023
Section Cited
HSC
1597.58(c)(2)
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Absence of supervision, including, but not limited to, a child left unattended and a child left alone with a person under 18 years of age.
This requirement was not met as evidenced by: Based on interviews, record review and the licensee’s statement, on 3/15/23 the licensee did not prevent Child 1 (C1) from leaving the facility. C1 was without supervision for at least 10 minutes.
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S1 stated that since that incident occurred, the Licensee does not allow parents come inside to prevent distractions. S1 stated when parents arrive they knock on the door and we have their child ready to go and they leave we lock the door behind them. S1 stated that the Licensee will be installing another gate on the side of the backyard that leads along the side of the home.
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This poses an immediate risk to the Health and Safety of children in care.
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On today's date, 11/21/23 Licensee stated she will not deny entry to parents. Parents will be allowed to come inside the home if they wish to do so. Licensee has agreed to email the statement to LPA by 11/29/23.
[email protected]
Type A
11/17/2023
Section Cited
HSC
1597.58(c)(3)
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Accessible bodies of water, when prohibited by this chapter or regulations adopted pursuant to this chapter.
This requirement was not met as evidenced by: Based on LPA Yang’s observation and photographs taken on 3/23/2023 of a wine barrel partially filled with water. This poses an immediate risk to the Health and Safety of children in care.

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S1 stated during the visit on 3/23/23 she dumped the water out of the half wine barrel, then turned it over.
CCR
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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: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 6
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
03/16/2023 and conducted by Evaluator Leticia Rosales
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20230316124635

FACILITY NAME:MUNOZ ARREOLA, CARMENFACILITY NUMBER:
493010084
ADMINISTRATOR:MUNOZ ARREOLA, CARMENFACILITY TYPE:
810
ADDRESS:2306 HOLLY CREEK DRIVETELEPHONE:
(707) 889-1056
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:14CENSUS: 13DATE:
11/17/2023
UNANNOUNCEDTIME BEGAN:
02:00 AM
MET WITH:Maria Medina and Migdalia DiazTIME COMPLETED:
04:45 PM
ALLEGATION(S):
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Licensee leaves day care children unattended for extended periods of time.

Licensee does not reside in the licensed facility.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA), Leticia Rosales-Meza conducted an unannounced follow-up complaint inspection to the facility for the purpose of delivering complaint findings, and met with licensee, Maria Medina and Migdalia Diaz. It has been alleged that the licensee leaves day care children unattended for extended periods of time, specifically, that children are seen in the backyard sitting alone in chairs and heard crying excessively without a care provider attending to their needs. It was also alleged that the licensee does not reside in the licensed facility, specifically, the licensee leaves the licensed facility at approximately 6:00pm and returns the following day between 8:00am-9:00am.

An interview conducted on 5/19/2023 by LPA Laura Chavez between 1:23pm -2:12pm with Licensee Carmen Munoz, who denied the allegations and stated children are never left unattended while in the outdoor play area. Licensee said she and or her assistants are present while the children are outside. Licensee stated she resides in the licensed home. LPA Laura Chavez conducted interviews on 6/13/2023, 6/21/2023, 11/7/2023, and 11/8/2023 with Parents #1, #2 and #3, #4, #6, and #7 stated that they had no knowledge of children being left unattended for extended periods of time and to the best of their knowledge the licensee resides in the home and she provides care to children.

Continue on LIC9099-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 6
Control Number 01-CC-20230316124635
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: MUNOZ ARREOLA, CARMEN
FACILITY NUMBER: 493010084
VISIT DATE: 11/17/2023
NARRATIVE
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On 11/8/2023 LPA Laura Chavez conducted an interview with the licensee’s assistant Staff 1 (S1) between 12:35pm – 12:39pm. S1 denied that children are left alone for extended periods of time, and that she and the licensee are always present with children while inside the home and or outside in the outdoor play area.

Although the allegations may have happened or are valid, there is not a preponderance of the evidence to prove that the alleged violations occurred, and the findings are Unsubstantiated. An exit interview was conducted. Appeal Rights and a Notice of Site Visit were given.

The Notice of Site Visit must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 6
Control Number 01-CC-20230316124635
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: MUNOZ ARREOLA, CARMEN
FACILITY NUMBER: 493010084
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/17/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/17/2023
Section Cited
CCR
102417(d)
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Operation of a Family Child Care Home: The home shall provide safe toys, play equipment, and materials.
This requirement was not met as evidenced by:
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S1 stated during the visit on 3/23/23 the metal stake was removed. S1 stated the other items mentioned were removed, replaced and repaired.
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Based on LPA Yang Yang’s observations, photographs, and video taken on 3/23/2023 of the outdoor play area of a canvas shade structure that had fallen over and lying on its side, a 2’ metal landscaping stake lying on the ground, two Pac ‘n Plays that were heavily damaged and strewn about the outdoor play area, the fence located on the right side of the outdoor play area leaning toward the neighbor's yard and a heating and/or air conditioning unit with exposed wires.
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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: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2023
LIC9099 (FAS) - (06/04)
Page: 6 of 6