<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 053614375
Report Date: 11/03/2023
Date Signed: 11/04/2023 10:40:03 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/09/2023 and conducted by Evaluator Corina Beckby
COMPLAINT CONTROL NUMBER: 53-CC-20230809154039
FACILITY NAME:STALCUP, MERLITAFACILITY NUMBER:
053614375
ADMINISTRATOR:MERLITA STALCUPFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(209) 785-2657
CITY:COPPEROPOLISSTATE: CAZIP CODE:
95228
CAPACITY:14CENSUS: 3DATE:
11/03/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Merlita StalcupTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/03/203, Licensing Program Analyst (LPA) Corina Beckby conducted an unannounced field visit to deliver the findings for the above allegation. LPA arrived at the facility and was met by Licensee Merlita Stalcup. LPA disclosed the purpose of the inspection and was granted entrance into the facility. Throughout the course of the investigation, LPA’s Lake and Beckby conducted physical plant inspections, on-site observations, and interviews. LPA’s conducted a file review and collected documentation pertaining to the allegation.

It was alleged that the Licensee fell asleep and left a child unattended. Licensee admits taking over the counter medicine for pain while the child was asleep. Licensee fell asleep and did not hear when the parent arrived, causing concern. The Licensee must remain awake at all times when there are children present to provide a safe environment for the children in care. Based on interviews, file reviews, and observations conducted the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. CONTINUED on 9099-C...

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
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 5
Control Number 53-CC-20230809154039
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: STALCUP, MERLITA
FACILITY NUMBER: 053614375
VISIT DATE: 11/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
page 2...

LPA informed Licensee, Merlita Stlacup, that this report dated 11/03/2023, documents a Type A citation that is an immediate Health and Safety, or Personal Rights risk to persons in care. An 809D is issued for the deficiency. Upon receipt of a Type A deficiency licensee shall post the report for 30 days in addition to the Notice of Site Visit and provide copies of the licensing report to parents/guardians of children in care at the facility. This report must be provided to parents/guardians of children newly enrolled at the facility during the next 12 months and Licensee will obtain a signed Acknowledgment of Licensing Reports (LIC9224) from parent/guardian and place it in each child's file. If these requirements are not met, civil penalties will be assessed.

An Exit interview was conducted, and the report was reviewed with Licensee, Merlita Stalcup. LPA posted a notice of site visit. Licensee understands the Notice must remain posted for 30 days and that a failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights were provided. A copy of this report will remain on file for a period of three years for public review upon request. The licensee's signature on this form acknowledges receipt of this form.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 53-CC-20230809154039
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827

FACILITY NAME: STALCUP, MERLITA
FACILITY NUMBER: 053614375
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/03/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/07/2023
Section Cited
CCR
102417(a)
1
2
3
4
5
6
7
102417 Operation of a Family Child Care Home (a) The licensee...shall ensure that children in care are supervised at all times.

This requirement is not met as evidenced by:

Based on interviews conducted and records
1
2
3
4
5
6
7
Licensee will watch training video “Supervising Children In Family Child Care. https://ccld.childcarevideos.org/family-child-care-providers/supervising-children-in-family-child-care/ Licensee will write a statement acknowledging she will remain awake, will no longer use the bunk bed area to rest while
8
9
10
11
12
13
14
reveiews, Licensee admits she fell asleep leaving a child unattended, which poses/posed an immediate health and safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
 children are present, and Licensee and assistant will rotate turns going inside and outside. Licensee will notify assistant when not feeling well. Licensee will date and sign the statement and submit it to the department by POC due date via email.
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.
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/09/2023 and conducted by Evaluator Corina Beckby
COMPLAINT CONTROL NUMBER: 53-CC-20230809154039

FACILITY NAME:STALCUP, MERLITAFACILITY NUMBER:
053614375
ADMINISTRATOR:MERLITA STALCUPFACILITY TYPE:
810
ADDRESS:2811 ARROWHEAD STREETTELEPHONE:
(209) 785-2657
CITY:COPPEROPOLISSTATE: CAZIP CODE:
95228
CAPACITY:14CENSUS: 3DATE:
11/03/2023
UNANNOUNCEDTIME BEGAN:
10:30 AM
MET WITH:Merlita StalcupTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/03/203, Licensing Program Analyst (LPA) Corina Beckby conducted an unannounced field visit to deliver the findings for the above allegations. LPA arrived at the facility and was met by Licensee Merlita Stalcup. LPA disclosed the purpose of the inspection and was granted entrance into the facility. Throughout the course of the investigation, LPA’s Lake and Beckby conducted physical plant inspections, on-site observations, and interviews. LPA’s conducted a file review and collected documentation pertaining to the allegations.

It was alleged a child's diapering needs were not met. The child had soaked through the diaper and leaked through the clothes. Some parent interviewed stated Licensee met diapering needs, while others stated she did not. Licensee does not keep a diaper changing schedule. Based on lack of clear corroborating evidence, the above allegation could not be substantiated or dismissed. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore, the finding is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 53-CC-20230809154039
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SACRAMENTO S. CC RO, 9835 GOETHE ROAD, SUITE 100
SACRAMENTO, CA 95827
FACILITY NAME: STALCUP, MERLITA
FACILITY NUMBER: 053614375
VISIT DATE: 11/03/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
page 2...

An exit interview was conducted in which the report was reviewed and discussed with the Licensee, Merlita Stalcup. LPA provided a copy of the report and Appeal Rights to Licensee. A Notice of Site Visit was posted by LPA and Licensee understands it must remain posted for 30 days. A Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

***This is an amended report.***
SUPERVISORS NAME: Bettina Engelman
LICENSING EVALUATOR NAME: Corina Beckby
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5