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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 483010333
Report Date: 01/26/2024
Date Signed: 01/26/2024 12:54:26 PM

Document Has Been Signed on 01/26/2024 12:54 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1450 NEOTOMAS AVENUE, STE. 100
SANTA ROSA, CA 95405
FACILITY NAME:REED, SHARLEAN FCCHFACILITY NUMBER:
483010333
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY: 8TOTAL ENROLLED CHILDREN: 4CENSUS: 3DATE:
01/26/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Sharlean Reed - LicenseeTIME COMPLETED:
01:15 PM
NARRATIVE
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Licensing Program Analyst (LPA), Melchisedeck Augustin made an unannounced Case Management (CM) visit and met with Licensee (LS), Sharlean Reed to deliver a deficiency because LS did not cross report and submit a Suspected Child Abuse Report (SCAR) to Solano County Child Welfare Services (CWS) as required. On 12/07/23, LS notified the Department of an incident involving suspected child abuse and/or neglect that occurred on 12/07/23, and at that time, the Department (CCLD) provided LS with blank copies of Unusual Incident Report (UIR) and SCAR that contained instruction on the second page which instructs on how to submit the SCAR. LS did not submit a SCAR to CWS and/or the proper authorities as required in Penal Code Section 11166(a) which required a Mandated Reporter to report incident of abuse or neglect to a designated agency as soon as practically possible by telephone and to submit a completed SCAR within 36 hours of receiving the information concerning the incident.

On 12/20/23, LS submitted a legible UIR to the Department, however; LS did not submit a SCAR to CWS. On 12/20/23, the Department completed and submitted a SCAR to CWS on behalf of LS to report the incident, and LS did not comply with the timeframes so CCL had to report it. According to LS's statement, she received a blank copy of the SCAR from CCLD, and she made several attempts to reach CWS, however; LS did not reach and did not submit a SCAR to CWS; and left town. LPA consulted with LS on reporting requirements and LS was referred to item III Reporting Responsibilities on second page of the form, and LS understood and acknowledged as a Mandated Reporter, she was responsible for reporting suspected child abuse and/or neglect, as defined in Penal Code Section 11165.6, of any child in care, in addition to reporting requirements pursuant to Penal Code Section 11166.

Exit interview conducted and report was reviewed with the Licensee, Sharlean Reed. A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. The following violation of the California Code of Regulations, Title 22; Division 12, was observed during today’s visit. See LIC 809-D. Appeal Rights were provided.
SUPERVISORS NAME: Leslie Lepori
LICENSING EVALUATOR NAME: Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2024
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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Document Has Been Signed on 01/26/2024 12:54 PM - It Cannot Be Edited


Created By: Melchisedeck Augustin On 01/26/2024 at 12:23 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: REED, SHARLEAN FCCH
FACILITY NUMBER: 483010333

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/05/2024
Section Cited
CCR
102416.2(c)(1)

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In addition to the events specified in Health and Safety Code Sections 1597.467(b)(1)(A) through (b)(1)(C), the licensee shall report the following events to the Department: Any suspected child abuse or neglect, as defined in Penal Code Section 11165.6, of any child in care, in addition to reporting requirements
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Licensee stated if she ever had to report suspected child abuse and/or neglect, she would follow protocol by notifying CCLD, and/or the property authories including CPS and submit SCAR with the property timeframes as required. LS stated she would produce a written statement detailing how she intends to comply with CCR102416.2(c), and LS would submit the statement to CCLD by 02/05/24 via mail, email or fax.
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pursuant to Penal Code Section 11166.

This requirement is not met as evidenced by: Based on the LS not complying with the timeframes to report a SCAR resulting in CCL having to report the SCAR. This posed a potential health, safety and/or personal rights risk to children in care.
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Email: melchisedeck.augustin@dss.ca.gov

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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:Leslie Lepori
LICENSING EVALUATOR NAME:Melchisedeck Augustin
LICENSING EVALUATOR SIGNATURE:
DATE: 01/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/26/2024


LIC809 (FAS) - (06/04)
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