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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073401548
Report Date: 11/09/2022
Date Signed: 11/09/2022 02:55:38 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/19/2022 and conducted by Evaluator Christina Watts
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20220919093629

FACILITY NAME:MCGRUDER, KIMBERLYFACILITY NUMBER:
073401548
ADMINISTRATOR:MCGRUDER, KIMBERLYFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 776-4466
CITY:ANTIOCHSTATE: CAZIP CODE:
94509
CAPACITY:14CENSUS: 14DATE:
11/09/2022
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Kimberly McGruderTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Physical Plant - children in off-limit area
INVESTIGATION FINDINGS:
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On 11/09/2022 at 1:30 PM, Licensing Program Analysts (LPAs) Christima Watts and Cherie Acosta conducted an Unannounced Subsequent Complaint Investigation at Kimberly McGruder family home. LPA met with licensee and explained purpose of investigation. Finding for the above allegation was delivered during the inspection.

Complainant alleges that children were in off limit area. It was determined that children were in an off limit area. Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

Exit interview was conducted with licensee, Kimberly McGruder. Appeal rights were provided.
A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECTIVE DAYS.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
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 5
Control Number 02-CC-20220919093629
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: MCGRUDER, KIMBERLY
FACILITY NUMBER: 073401548
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/14/2022
Section Cited
CCR
102416.3(a)(6)
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102416.3 Alterations to Existing Buildings or Grounds(a)Prior to making alterations or additions to a family child care home...the licensee shall notify the Department of the proposed changed...(6) Any change from an area of the family child care home previously identified as "off limits" to an area where care and supervision will be provided...
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By COB 11/14/2022, licensee will write a statement about how they will keep children out of an off limit area.
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This requirement is has not been met as evidenced by: Based on interviews, the licensee did not comply with the section cited above by children entering an off limit area which poses an potential risk to the health, safety or personal rights 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.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Christina Watts
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 5