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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010206066
Report Date: 08/06/2025
Date Signed: 08/06/2025 12:49:41 PM

Substantiated


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
08/04/2025 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20250804124746
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:
08/06/2025
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Facility incharge, Karla Diaz TIME COMPLETED:
12:00 PM
ALLEGATION(S):
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The facility did not notify the department about alterations to the building
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini conducted an unannounced inspection to initiate a complaint investigation. LPA Saini met with the person in charge, Karla Diaz, as the director was not present. LPA Saini explained the purpose of the inspection. Present during today’s visit were four (4) fingerprint-cleared staff members supervising nine (9) infants.
Based on interviews, observations, and a review of records, LPA determined that the room previously designated under the preschool license is currently being used to accommodate infants without prior notification to the Community Care Licensing Division (CCLD), without completion of the required licensing inspection, and without meeting fire clearance requirements. 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 101237 (a) is being cited on the attached LIC 9099D
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
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 4
Control Number 52-CC-20250804124746
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: 08/06/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/07/2025
Section Cited
CCR
101237(a)
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101237 Alterations to Existing Buildings or New Facilities
(a) Prior to construction or alterations, the licensee shall notify the Department of the proposed change(s).
This requirement is not met as evidenced by:
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The facility shall immediately discontinue use of the room. Infant occupancy in the room shall not resume until all licensing requirements have been met and written authorization has been issued by the Community Care Licensing Division.
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Based on observations, interviews, and record reviews, the facility did not comply with the section cited above. The Licensing Program Analyst (LPA) observed that the room previously designated for the preschool license is currently being used to accommodate infants without prior notification to the Community Care Licensing Division and before meeting the necessary inspection requirements, which poses a immediate 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: 08/06/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 52-CC-20250804124746
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
VISIT DATE: 08/06/2025
NARRATIVE
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As a result of the Type A deficiency cited during today’s inspection, a copy of this report and LIC 9224 Acknowledgment of Receipt of Licensing Reports must be provided to parents/guardians of current enrolled children in care and all children newly enrolled following a 12-month period of this report. The LIC 9224 must be signed within the next business day the children are in care and is to be kept in the children’s files.

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 person in charge, Karla Diaz.
SUPERVISOR'S NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4