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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 493010084
Report Date: 04/08/2024
Date Signed: 04/08/2024 05:25:37 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
04/03/2024 and conducted by Evaluator Leticia Rosales
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240403110155

FACILITY NAME:MUNOZ ARREOLA, CARMEN FCCHFACILITY NUMBER:
493010084
ADMINISTRATOR:MUNOZ ARREOLA, CARMENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 889-1056
CITY:SANTA ROSASTATE: CAZIP CODE:
95404
CAPACITY:14CENSUS: 7DATE:
04/08/2024
UNANNOUNCEDTIME BEGAN:
11:40 AM
MET WITH:Carmen Munoz ArreolaTIME COMPLETED:
05:45 PM
ALLEGATION(S):
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Facility is out of ratio.
INVESTIGATION FINDINGS:
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An unannounced 10 day complaint investigation inspection was made to the facility by
Licensing Program Analyst (LPA), Leticia Rosales-Meza. It has been alleged that facility is out of ratio. On this date, 4/08/24 at 2:30 PM, LPA observed seven children being supervised by Licensee and S1, there were five infants under 24 months, and two preschool aged children resulting in the facility, operating out of ratio.

During the course of an inspection, LPA toured the facility inside and outside. LPA met with Licensee, Carmen Munoz Arreola at 2:35 PM on 4/08/24 to discuss the allegation. Licensee admits operating out of ratio. Licensee stated she is over ratio with one infant in care. LPA requested a current Children's Facility Roster.

Based on available information, records reviewed and LPA observations the preponderance of evidence standard has been met, therefore, the allegation is Substantiated. The following violations of the California Code of Regulations, Title 22; Division 12, were observed: see LIC 9099D. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled. This report was reviewed and discussed with the Licensee.
Notice of Site Visit shall be posted for 30 days from today's visit.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Alexis Hollon
LICENSING EVALUATOR NAME: Leticia Rosales
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024
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 3
Control Number 01-CC-20240403110155
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 FCCH
FACILITY NUMBER: 493010084
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/08/2024
Section Cited
HSC
1597.465(b)
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Staffing Ratio and Capacity: A large family day care home may provide care for more than 12 children and up to and including 14 children, if all of the following conditions are met. No more than three infants are cared for during any time when more than 12 children are being cared for.
This requirement was not met as evidenced by:
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Licensee stated I will not accept an infant in care who is not scheduled to come on that day. I will speak with all the parents to let them know they can't just drop-off their infant and need to call prior.
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During today's inspection, on this date, 4/08/24 there were 7 children present, 5 which were infants, resulting in the facility being out of ratio. This poses/posed an immediate health, safety and/or personal rights risk to the children in care.
A $250.00 Civil Penalty was assessed for being out of ratio.
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Licensee agreed to submit a written statement to CCLD on or before 4/09/2024. The written statement shall included the names of infants, days and hours in care or if needs to terminated an infant from her care to ensure staying in compliance.
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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: 04/08/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3