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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 553601807
Report Date: 12/16/2019
Date Signed: 12/16/2019 11:47:48 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833
FACILITY NAME:MCKAY, SUSANFACILITY NUMBER:
553601807
ADMINISTRATOR:MCKAY, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 533-2871
CITY:SONORASTATE: CAZIP CODE:
95370
CAPACITY:14CENSUS: 0DATE:
12/16/2019
TYPE OF VISIT:Case Management - Legal/Non-complianceANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Susan McKay, LicenseeTIME COMPLETED:
12:00 PM
NARRATIVE
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Regional Manager (RM) Thomas Stahl, Licensing Program Manager (LPM) Jeanne Smith, and Licensing Program Analyst (LPA) Justin Denton met with Licensee Susan McKay and her daughter, regarding an incident that occurred on 9/30/19 and reported to Community Care Licensing (CCL) on the same date.

On 9/30/19 at about 10:45 AM, the Sacramento South Office received an incident report from Licensee Susan McKay stated that a child left her Family Child Care Home without adult supervision between 6:30 AM and 7:00 AM. Interviews revealed that a passerby, found Child 1 on the side of the road near the intersection of Campbells Flat Road and Avenida Bonita in Sonora, CA, on or about 7:20 AM to 7:30 AM. The passerby returned Child 1 to McKay’s home. Upon Bentley's return to the front door, McKay was asleep on the couch while an infant, Child 2, was asleep in a nearby car seat.

Due to the seriousness of the above incident, a Type A deficiency was issued for the child leaving the home without adult supervision. In addition, a Type A deficiency is being cited for the licensee allowing an infant to sleep in a car seat. The Licensee will be cited under California Code of Regulations Title 22 on the attached LIC809-D.

This report was discussed with the Licensee and appeal rights were provided.
SUPERVISOR'S NAME: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 2525 NATOMAS PARK DR. STE 250
SACRAMENTO, CA 95833

FACILITY NAME: MCKAY, SUSAN
FACILITY NUMBER: 553601807
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/16/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
12/17/2019
Section Cited

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Operation of a Family Care Home: The licensee shall be present in the home and shall ensure that children in care are supervised at all times. (...) This requirement was not met as evidenced by:
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A child left the home without adult supervision. This is an immediate risk to the health and safety of children in care.
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Licensee will submit a copy of the policy to CCL by the due date:
Type A
12/17/2019
Section Cited

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Personal Rights: Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following:
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(...) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by: Evidence showed that a child asleep in a car seat. This is an immediate risk to the health and safety of children in care.
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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: Jeanne SmithTELEPHONE: (916) 208-4405
LICENSING EVALUATOR NAME: Justin L DentonTELEPHONE: (916) 926-9269
LICENSING EVALUATOR SIGNATURE:
DATE: 12/16/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/16/2019
LIC809 (FAS) - (06/04)
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