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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 455406395
Report Date: 11/06/2020
Date Signed: 11/09/2020 12:14:34 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/22/2020 and conducted by Evaluator Carrie Wisehart
PUBLIC
COMPLAINT CONTROL NUMBER: 13-CC-20200922140608
FACILITY NAME:FORD, CANDACE FAMILY CHILD CARE HOMEFACILITY NUMBER:
455406395
ADMINISTRATOR:FORD, CANDACEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(530) 221-7874
CITY:REDDINGSTATE: CAZIP CODE:
96002
CAPACITY:14CENSUS: DATE:
11/06/2020
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Candace FordTIME COMPLETED:
09:40 AM
ALLEGATION(S):
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Licensee did not cross report incident to appropriate authorities.
INVESTIGATION FINDINGS:
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On 11/6/20 Licensing Program Analyst (LPA) Carrie Wisehart conducted a subsequent complaint investigation inspection to the facility via tele-inspection due to the current state of emergency regarding the COVID-19 outbreak, for the purpose of delivering complaint findings. The allegations were investigated by the Departments Investigations Branch (IB), by Investigator Nancy Saechao. It was alleged that licensee did not cross report incident to appropriate authories.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2020
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 13-CC-20200922140608
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926
FACILITY NAME: FORD, CANDACE FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406395
VISIT DATE: 11/06/2020
NARRATIVE
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The licensee was interviewed on 10/8/2020 and acknowledged not reporting the incident that was alleged to have happened between C1 and C2 on 8/27/20.
The licensee admitted she first became aware of the incident on 8/27/20 and stated she had no information confirming the incident actually happened, therefore, she chose not to report it. The LPA determined the licensee failed to notify the Department of an unusual incident whose allegations could have threaten the physical or emotional health or safety of any child, as required.

Based on the evidence obtained, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, (Title 22), is being cited on the attached LIC 9099D. Appeal rights were provided and exit interview conducted. The Notice of Site Visit must be posed for 30 day
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 13-CC-20200922140608
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 520 COHASSET RD., SUITE 170
CHICO, CA 95926

FACILITY NAME: FORD, CANDACE FAMILY CHILD CARE HOME
FACILITY NUMBER: 455406395
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/06/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/20/2020
Section Cited
CCR
102416.2
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Reporting Requirements 102416.2
(b) (3) (C) The licensee shall report to the Department any of the events as specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C) that occur during the operation of the family childcare home.
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Licensee to watch Child Care Reporting Any unusual incident or child absence that threatens the physical or emotional health or safety of any child."Requirements training video.
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This requirement was not met as evidenced by: Based on record review and interviews conducted, the Licensee acknowledged on 10/8/20 she failed to report the alleged unusual incident that may have occurred at the facility between C1 and C2 as required. This poses a potential risk to children in care.
, including Mandated Reporting. A written confirmation of completion will be sent to CCL by Nov 20, 2020.


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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.
SUPERVISOR'S NAME: Megan AvilesTELEPHONE: (530) 895-5984
LICENSING EVALUATOR NAME: Carrie WisehartTELEPHONE: (530) 895-5824
LICENSING EVALUATOR SIGNATURE:

DATE: 11/06/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/06/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3