483008976-10-17-2019-01-CC-LLEI-BHJ36K-20191101175827

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 483008976
Report Date: 10/17/2019
Date Signed: 10/17/2019 10:19:05 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

This is an official report of an unannounced visit/investigation of a complaint received in our office on
10/01/2019 and conducted by Evaluator Glenn Ouye

COMPLAINT CONTROL NUMBER: 01-CC-20191001160106

FACILITY NAME:	MCMURRY, TINA FCCH		FACILITY NUMBER:	483008976
ADMINISTRATOR:	MCMURRY, TINA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(707) 280-3742
CITY:	SUISUN CITY	STATE: CA	ZIP CODE:	94585
CAPACITY:	14	CENSUS:	DATE:	10/17/2019
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Tina McMurry		TIME COMPLETED:	10:30 AM

ALLEGATION(S):

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Licensee failed to pick child up from school.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Ouye arrived to deliver findings regarding the allegation that Licensee failed to pick child up from school.
LPA Ouye interviewed the licensee on 10/7/19 at 11:15am. The licensee stated to LPA Ouye that on 9/27/19 she arrived at the child C1's school to pick up C1 and two other children who attend the same school. The school ends at 2:05pm and all of the children who are being picked up go into the auditorium and wait for the person(s) picking up the children. The licensee arrived at the school at approximately 2:15pm. Two of the three children came out to the licensee's car but C1 did not. The licensee said that she thought that C1's father already picked up C1 so the licensee left the school and headed back for the facility. At approximately 1 mile from the school the licensee received a call on her cell phone from the responsible party of C1 advising her that C1 was still at the school. The licensee turned back and returned to the school and picked up C1. The licensee said that she was returning to the facility because she thought C1's father had already picked up C1 from the school and father was going to the facility to pick up C1's sibbling.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn Ouye	TELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20191001160106

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: MCMURRY, TINA FCCH	FACILITY NUMBER: 483008976
	VISIT DATE: 10/17/2019

NARRATIVE

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On 10/9/19 LPA Ouye interviewed the school office staff who was present when C1 was not picked up. The staff indicated that C1 was brought to the office along with other children because he was not picked up. The school staff called C1's responsible party. The staff said that C1 was picked up shortly after calling the responsible party. The staff said that they do not have a sign out log but C1 recognized the person who arrived to do the pick up and C1 left with the person.

Based on the interview of the licensee and the school staff the child was supervised at all times, however the licensee failed to initiate care of child at the expected time. The allegation that the licensee failed to pick child up from school is substantiated. As a result the incident, the licensee agrees to determine the location of a child prior to leaving the school if a child is not present during pick up time at the school.

The following violation(s) of the California Code of Regulation, Title 22, Division 12, were observed; see LIC9099D. Appeal rights were provided.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn Ouye	TELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC9099 (FAS) - (06/04)

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Control Number 01-CC-20191001160106

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 101 GOLF COURSE DR. STE. A-230
ROHNERT PARK, CA 94928

FACILITY NAME: MCMURRY, TINA FCCH	FACILITY NUMBER: 483008976
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/17/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 10/25/2019 Section Cited CCR 102417(a)	1 2 3 4 5 6 7	Operation of a Family Child Care Home-The licensee shall be present in the home and shall ensure that children in care are supervised at all times. This requirement has not been met as evidenced by statements of interviews of licensee on 10/7/19 and school office staff on 10/9/19 that child C1 was not picked up by	1 2 3 4 5 6 7	The licensee provided CCL with a written statement indicating that any time a child that is to be picked up is not delivered to the facility staff, that the staff will locate or determine the whereabouts of the child to ensure child pick up occurs if the child is still at school.
	8 9 10 11 12 13 14	licensee at the scheduled time and was left at school until licensee was notified that C1 was still at school & needed to be picked up. This poses a potential risk to safety of the child who is attends this facility.	8 9 10 11 12 13 14	Deficiency cleared at time of visit.
	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.

SUPERVISOR'S NAME: Leslie Lepori	TELEPHONE: (707) 588-5060
LICENSING EVALUATOR NAME: Glenn Ouye	TELEPHONE: (707) 588-5042
LICENSING EVALUATOR SIGNATURE:	DATE: 10/17/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019

LIC9099 (FAS) - (06/04)

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