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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 173008720
Report Date: 09/20/2024
Date Signed: 09/20/2024 10:27:13 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2024 and conducted by Evaluator Sebastian Phouthavong
PUBLIC
COMPLAINT CONTROL NUMBER: 01-CC-20240628162349
FACILITY NAME:MCBRAYER, MICHELLE FCCHFACILITY NUMBER:
173008720
ADMINISTRATOR:MCBRAYER, MICHELLEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 994-9580
CITY:CLEARLAKESTATE: CAZIP CODE:
95422
CAPACITY:14CENSUS: 3DATE:
09/20/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Michelle McBrayerTIME COMPLETED:
10:40 AM
ALLEGATION(S):
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Licensee did not ensure the safety of day care children around pets.
INVESTIGATION FINDINGS:
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An unannounced inspection was conducted today by Licensing Program Analyst (LPA), Sebastian Phouthavong, who met with Licensee, Michelle McBrayer, to deliver the finding of the complaint investigation of the above allegation. LPA previously met with Licensee on 07/03/2024 to open the complaint investigation and obtain records. This complaint was investigated by Investigator, Bikramjit Birk, of the Department’s Investigative Branch, which alleged that the Licensee did not ensure the safety of a day care child when around pet(s), specifically that the dog in the facility bit a child (C1).

During the complaint investigation from 06/28/2024 through 08/06/2024, Investigators Bikramjit Birk and Christen Krogstad, conducted interviews with the licensee, staff, children, and adults and reviewed records. The Licensee admitted her dog bit C1 when C1 got excited while watching a movie and slammed their face and hands on the couch, accidently hitting the dog who got startled and bit C1’s right cheek. Licensee also admitted the dog growling at day care children as the dog has become grumpier due to increasing teeth pain a year ago. Licensee does not feel comfortable locking up the dog due to its medical condition.
(Continued on LIC 809)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
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 3
Control Number 01-CC-20240628162349
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME: MCBRAYER, MICHELLE FCCH
FACILITY NUMBER: 173008720
VISIT DATE: 09/20/2024
NARRATIVE
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(Continued from LIC 809)

****This is an Amended Report from original Report Dated 09/20/2024****

Four daycare children disclosed that the dog does growl and/or tries to nip or bite at children. One child further stated the dog is old and he nips and tries to bite while another child stated the rules are not to get close to the dog because he will growl and bite. One staff confirmed the rules for the dog are not to mess with the dog and/or leave him alone and to be gentle with him due to health issues. Three adult interviews also confirmed that the Licensee refused to put the dog away or in a separate room.

Upon review of medical records, it was confirmed that C1 sustained a dog bite to right cheek which required three stitches to close the wound and antibiotics.

Based on the investigation, evidence shows that the Licensee did not provide a safe environment to children in care resulting in a dog at the facility biting a child who sustained an injury requiring medical attention. Therefore, the preponderance of the evidence standard has been met and the allegation is determined to be substantiated. California Code of Regulations, Title 22, is being cited on the attached LIC 9099-D and due to the extent of the personal rights violation resulting in a serious injury of a child, the licensee is being issued a Civil Penalty (CP) in the amount of $2000 in accordance with Health and Safety Code 1597 .58(f)(l)(B). LPA reviewed and provided Licensee with a copy of this report and the Civil Penalty Assessment-Physical Abuse (LIC421D(CC) during the exit interview. The Notice of Site Visit shall be posted for 30 days. Appeal rights were provided.



LPA informed Licensee that this report documenting a Type A citation shall be posted for 30 consecutive days as there is an immediate risk to the health, safety, or personal rights of children in care and to provide a copy of this licensing report to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 01-CC-20240628162349
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SANTA ROSA RO, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405

FACILITY NAME: MCBRAYER, MICHELLE FCCH
FACILITY NUMBER: 173008720
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/23/2024
Section Cited
CCR
102423(a)(2)
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9099D: 102423 (a)(2) - Personal Rights: (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged ... These rights include ... : (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment. This requirement is not met as evidenced by:
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Licensee stated she will ensure to provide a dog playpen to separate the dog from the daycare children during the hours of operation and submit a plan regarding the dog for when the FCCH is operational to the department.
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Based on the Licensee's admission, interviews, and medical records, a dog in the facility bit a child in the check resulting in injury requiring medical treatment. This poses an immediate health and safety risk to children in care. A civil penalty of $2000 is being issued for violation of regulation resulting in a serious injury.
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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: Leslie Lepori
LICENSING EVALUATOR NAME: Sebastian Phouthavong
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2024
LIC9099 (FAS) - (06/04)
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