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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 173002579
Report Date: 01/10/2022
Date Signed: 01/10/2022 01:11:16 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,
, CA
This is an official report of an unannounced visit/investigation of a complaint received in our office on
01/07/2022 and conducted by Evaluator Kevin O'Connell
COMPLAINT CONTROL NUMBER: 01-CC-20220107140208
FACILITY NAME:NCO HEAD START - MEADOWBROOK CENTERFACILITY NUMBER:
173002579
ADMINISTRATOR:LUCCHESI, VALERIEFACILITY TYPE:
850
ADDRESS:6958 MEADOWBROOK AVENUETELEPHONE:
(707) 994-0854
CITY:CLEARLAKESTATE: CAZIP CODE:
95422
CAPACITY:24CENSUS: 10DATE:
01/10/2022
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Jody Mederos, Site Supervisor & Denise Villalobos, Lead Teacher.TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility is in disrepair.
Facility does not maintain minimum temperature of 68 degrees in rooms where children are present.
INVESTIGATION FINDINGS:
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LPA Kevin O'Connell made an unannounced inspection to open a complaint regarding the two allegations above and met with Site Supervisor,Jody Mederos (S1) and Lead teacher, Denise Villalobos (S2).
It was alleged that the facility is in disrepair, specifically that the main heater which provided heat for the sole classroom has failed and is broken.

It was also alleged that the facility does not maintain minimum temperature of 68 degrees in rooms where children are present.

Staff were interviewed, repair documents were obtained and observations were made.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022
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-20220107140208
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA
FACILITY NAME: NCO HEAD START - MEADOWBROOK CENTER
FACILITY NUMBER: 173002579
VISIT DATE: 01/10/2022
NARRATIVE
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S1 & S2 admitted/ confirmed that the main heater for the classroom did break in November and that a repair company was called November 17, repairs were quoted November 18th and repairs started early December but were halted because they are waiting for parts due to supply chain issues.
Upon arrival on 1/10/22 at 10:05am, LPA observed that the indoor temperature reading on the wall thermostat was 66 degrees which is below the 68 degree minimum regulation temperature in a room where children are present. S2 also stated that the classroom was cold in the mornings when the children arrived due to the heat being off overnight before the space heaters were upgraded the beginning of January when space heaters would be left on overnight.

Based on interviews, observations and document review, the preponderance of evidence standard has been met; therefore, the above allegations are found to be SUBSTANTIATED. The following violation of the California Code of Regulations, Title 22; Division 6, was observed: see LIC 9099-D. This report was reviewed and discussed with S1. Appeal Rights were provided, and exit interview was conducted. All licensing reports are public information and must be made available upon request for at least three years. S1 was provided with a Notice of Site Visit (NOS) to be posted in the facility for 30 days.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20220107140208
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office,
, CA

FACILITY NAME: NCO HEAD START - MEADOWBROOK CENTER
FACILITY NUMBER: 173002579
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
01/24/2022
Section Cited
CCR
101239(n)
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101239 Fixtures, Furniture, Equipment and Supplies.
(n) Furniture and equipment shall be maintained in good condition.

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Staff states that they will forward a copy of the final repair document to CCL by February 10th, 2022.
[email protected]
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This requirement was not met as evidenced by:
S1 & S2 admitted that the main heater broke/ stopped working in November and was partially repaired but the repair company is waiting on parts to complete the repairs. This is a potential risk to the health and safety of children in care.
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Type B
02/10/2022
Section Cited
CCR
101239(a)(1)
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101239 Fixtures, Furniture, Equipment and Supplies.
(a) A comfortable temperature for children shall be maintained at all times.

(a) A comfortable temperature for children shall be maintained at all times.

(1) The licensee shall maintain the temperature in rooms that children occupy between a minimum of 68 degrees F.
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S1 states that they will leave the heaters on overnight at a temperature of 68 and document the temperature upon opening and makes adjustments accordingly.
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This requirement was not met as evidenced by:
S2 also stated that the classroom was cold in the mornings when the children arrived due to the heat being off overnight and LPA observed that the temperature was 66 degrees at 10:05am on 1/10/22.
This is a potential risk to the health and safety of children in care.
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[email protected]
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: Leslie Lepori
LICENSING EVALUATOR NAME: Kevin O'Connell
LICENSING EVALUATOR SIGNATURE:

DATE: 01/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/10/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3