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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 573622392
Report Date: 02/10/2022
Date Signed: 02/10/2022 11:07:37 AM

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
02/07/2022 and conducted by Evaluator Aruna Sridharan
COMPLAINT CONTROL NUMBER: 53-CC-20220207094636
FACILITY NAME:KANDELA, SUSANFACILITY NUMBER:
573622392
ADMINISTRATOR:KANDELA, SUSANFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(707) 628-3555
CITY:WEST SACRAMENTOSTATE: CAZIP CODE:
95691
CAPACITY:14CENSUS: 9DATE:
02/10/2022
UNANNOUNCEDTIME BEGAN:
09:17 AM
MET WITH:Susan KandelaTIME COMPLETED:
11:30 AM
ALLEGATION(S):
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9
Criminal Record Clearance: Uncleared adult caring for children
INVESTIGATION FINDINGS:
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On 2/10/2022 at 9: 00 am Licensing Program Analysts (LPAs) Aruna Sridharan and Erwin Tjhia arrived at the facility. At the facility, there were two assistants and census was 9 children which included two infants and 7 preschoolers. Licensee arrived at the faciity within 10 minutes. LPAs stated the purpose of the visit to open a complaint. LPAs observed care and supervision. Staff 1 did not have fingerprint clearance. LPA discussed the complaint allegation with licensee about uncleared adult providing care for children. Lcensee stated her assistant S1 has been employed for two days. Licensing staff verified that S1 does not have fingerprint clearance. Based on the information obtained the allegation is substantiated.

Title 22 Deficiencies have been cited on the attached LIC 9099D. Upon receipt of Type A citations, facility shall post and provide copies of the LIC 9099D for parents/guardians of children currently in care and for parents/guardians of newly enrolled children for the next 12 months. Facility must also keep the signed LIC 9224, Acknowledging Receipt of Licensing Reports LIC 9099D in each child's files.
This report was reviewed and discussed with licensee. A notice of site visit and appeal rights were provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Justin L Denton
LICENSING EVALUATOR NAME: Aruna Sridharan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
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 3
Control Number 53-CC-20220207094636
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: KANDELA, SUSAN
FACILITY NUMBER: 573622392
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/10/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/10/2022
Section Cited
CCR
102370(d)(1)
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All individuals subject to a criminal record review shall obtain a criminal record clearance or exemption prior to working, residing or volunteering in a licensed home. This was not evidenced by;
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The licensee will not allow Staff 1 to work until they get fingerpint clearance.
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The licensee had Staff 1 who was not fingerprint cleared.
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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: Justin L Denton
LICENSING EVALUATOR NAME: Aruna Sridharan
LICENSING EVALUATOR SIGNATURE:

DATE: 02/10/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3