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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010216245
Report Date: 08/29/2022
Date Signed: 08/29/2022 11:25:01 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, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/28/2022 and conducted by Evaluator Indira Loza
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20220628130410
FACILITY NAME:UCB - CLARK KERR CAMPUS CHILDREN'S CENTERFACILITY NUMBER:
010216245
ADMINISTRATOR:DARRELL WHITACREFACILITY TYPE:
850
ADDRESS:2900 DWIGHT WAY, BLDG. #5TELEPHONE:
(510) 643-5527
CITY:BERKELEYSTATE: CAZIP CODE:
94720
CAPACITY:17CENSUS: 8DATE:
08/29/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Pratibha ChaayaTIME COMPLETED:
11:35 AM
ALLEGATION(S):
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Personal Rights - Facility staff interacted inappropriately with day care child
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Indira Loza and Licensing Program Manager (LPM) Mayla Mendoza conducted an unannounced visit to investigate the above allegation.

During the investigation LPA and LPM conducted interviews with staff and children. Although inappropriate touching and kissing did not occur at the center, there were instances where teachers initiated hugs.

Based on interviews and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Boris Alvarado.
Substantiated
Estimated Days of Completion: 90
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022
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 2
Control Number 02-CC-20220628130410
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: UCB - CLARK KERR CAMPUS CHILDREN'S CENTER
FACILITY NUMBER: 010216245
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/29/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/29/2022
Section Cited
CCR
101223(a)(1)
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(a) The licensee shall ensure that each child is accorded the following personal rights:
(1) To be accorded dignity in his/her personal relationships with staff and other persons.
This requirement was not met as evidenced by staff interviews which revealed that staff iniated hugs with children.
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Staff will have a meeting in regards to children's personal rights. Director shall email the LPA a copy of minutes of the meeting, as well as signatures of all staff who attended the meeting. POC is due by September 28, 2022.
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This poses a potential health and safety risk to 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: Mayla MendozaTELEPHONE: (510) 292-9724
LICENSING EVALUATOR NAME: Indira LozaTELEPHONE: 510-368-3672
LICENSING EVALUATOR SIGNATURE:

DATE: 08/29/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/29/2022
LIC9099 (FAS) - (06/04)
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