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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 343624142
Report Date: 09/15/2022
Date Signed: 09/15/2022 02:44:06 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, 2525 NATOMAS PARK DR. STE.250
SACRAMENTO, CA 95833
This is an official report of an unannounced visit/investigation of a complaint received in our office on
09/09/2022 and conducted by Evaluator Josiah Gathing
PUBLIC
COMPLAINT CONTROL NUMBER: 03-CC-20220909161942
FACILITY NAME:MCCLARA, XIAOPINGFACILITY NUMBER:
343624142
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 2DATE:
09/15/2022
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Xiaoping McClaraTIME COMPLETED:
02:50 PM
ALLEGATION(S):
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Licensee is providing unsafe equipment
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Josiah Gathing met with Licensee Xiaoping McClara, on September 15, 2022 at approximately 10:30 AM to open and close the above complaint investigation. The complaint alleged the licensee was providing unsafe equipment in the facility. During the investigation, LPA observed a bassinet in the facility. LPA advised Licensee that the safe sleep regulations only authorize cribs and play yards. Additionally, LPA advised Licensee that the safe sleep Frequently Asked Questions found on the California Department of Social Services website indicate that bassinets are not authorized for use in childcare. Licensee stated that a different analyst advised that only items that have been recalled by the manufacturer would not be authorized for use in a childcare home. LPA confirmed that Licensee's analyst previously stated that currently there is nothing in the regulations regarding bassinets for the family child care home. LPA discussed this with Licensing Program Manager who agreed that the violation could be downgraded from Type A to Type B as a result.

CONT. ON LIC 9099-C...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
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 4
Control Number 03-CC-20220909161942
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: MCCLARA, XIAOPING
FACILITY NUMBER: 343624142
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/15/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
09/16/2022
Section Cited
CCR
102425(a)(1)
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102425 Infant Safe Sleep (a) There shall be one crib or play yard for each infant... (1) All cribs or play yards shall meet the United States Consumer Product Safety Commission safety standards.
This requirement was not met as evidienced by:
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The bassinet was removed and placed in an off-limits area during today's investigation, which returned the facility to compliance. The citation was cleared the same day.
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Based on observation the facility did not comply with the above regulation as there was unapproved equipment in the sleeping area which poses a Health, Safety, or Personal Rights risk to persons 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: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 03-CC-20220909161942
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: MCCLARA, XIAOPING
FACILITY NUMBER: 343624142
VISIT DATE: 09/15/2022
NARRATIVE
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Based on observation, the preponderance of evidence standard has been met, and the allegation is substantiated. A Type B citation was issued for the violation (see attached LIC 9099-D for violation and Plan of Correction details). The bassinet was moved to an off-limits area, and the facility was returned to compliance during today’s investigation.
LPA discussed this report with facility representative and conducted an exit interview. LPA also provided appeal rights. Director's signature on this report acknowledges receipt of these rights. This report was reviewed with the Director. An exit interview was conducted. A Notice of Site Visit was provided and shall remain posted for a period of 30 days.
SUPERVISORS NAME: Seychelle De Luca
LICENSING EVALUATOR NAME: Josiah Gathing
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4