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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010206066
Report Date: 02/05/2025
Date Signed: 02/05/2025 11:08:31 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2024 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20241209103443
FACILITY NAME:RESURRECTION LUTHERAN INFANT CARE CENTERFACILITY NUMBER:
010206066
ADMINISTRATOR:BHAVYA DOSHIFACILITY TYPE:
830
ADDRESS:7557 AMADOR VALLEY BOULEVARDTELEPHONE:
(925) 828-2122
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:36CENSUS: 9DATE:
02/05/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director, Bhavya Doshi TIME COMPLETED:
11:00 AM
ALLEGATION(S):
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9
- Facility does not have adequate staffing.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with Director Bhavya Doshi and explained the purpose of the inspection. Present during the inspection, the director, two (2) teachers, and two teacher aids supervising nine infants.
Based on interviews and record reviews, the LPA concluded that the facility has sufficient staffing to maintain the required child-to-teacher ratio. The facility holds an infant license, and the classroom designated for infants is divided into two sections to accommodate early and older infants. The LIC 500 (Personnel report), along with the sign-in/sign-out sheets, indicate that a fully qualified teacher and aides are consistently present to meet the required ratio at all time which concludes that although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is "Unsubstantiated".
Notice of Site visit was provided and appeal rights were given.
An exit interview was conducted, and the report was reviewed with the facility representative, Bhavya Doshi.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/09/2024 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20241209103443

FACILITY NAME:RESURRECTION LUTHERAN INFANT CARE CENTERFACILITY NUMBER:
010206066
ADMINISTRATOR:BHAVYA DOSHIFACILITY TYPE:
830
ADDRESS:7557 AMADOR VALLEY BOULEVARDTELEPHONE:
(925) 828-2122
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:36CENSUS: 9DATE:
02/05/2025
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Director, Bhavya Doshi TIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
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5
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8
9
-Staff did not provide proper medication assistance to child in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with Director Bhavya Doshi and explained the purpose of the inspection. Present during the inspection, the director, two (2) teachers, and two teacher aids supervising nine infants.
Based on the interviews conducted, the Licensing Program Analyst (LPA) determined that although the facility followed the direction of the parent, based on record review, the facility does not have an Incidental Medical Services policy in placed prior to administering the medication. The preponderance of evidence standard has been met; therefore, the allegation is found to be SUBSTANTIATED. California Code of Regulations, {Title 22, Division 12, Chapter 1, Section 101226(e)(5) is being cited on the attached LIC 9099D
Appeal rights were given.
A notice of site visit was posted and must remain posted for a period of 30 days.
An exit interview was conducted with Director Bhavya Doshi.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 52-CC-20241209103443
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: RESURRECTION LUTHERAN INFANT CARE CENTER
FACILITY NUMBER: 010206066
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/17/2025
Section Cited
CCR
101226(e)(5)
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101226 Health-Related Services
(e) In centers where the licensee chooses to handle medications:(5) The licensee shall develop and implement a written plan to record the administration of prescription and nonprescription medications and to inform the child's authorized representative daily when such medications have been given.
This requiremnet is not met as evidenced by:
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The director shall submit a written Incidental Medical Services (IMS) plan to the Community Care Licensing Division (CCLD) by the POC date. The facility was referred to follow the instructions outlined in PIN 22-02-CCP to develop the IMS plan.
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Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above.The facility failed to maintain an IMS plan for the child in the file which poses a potential risk to the health, safety, and personal rights of the children 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.
SUPERVISOR'S NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 3