013414711-7-3-2019-02-CC-ARON-BDXU2W-20190710151237

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013414711
Report Date: 07/03/2019
Date Signed: 07/03/2019 05:03:41 PM

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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8
9

Licensee having inappropriate conversations in front of daycare children

INVESTIGATION FINDINGS:

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3
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5
6
7
8
9
10
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12
13

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

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 10

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:	5621 MORSE DRIVE		TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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7
8
9

Uncleared Adult Living in the home.

INVESTIGATION FINDINGS:

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10
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12
13

LPA Dyer and LPM Robinson conducted an unannounced complaint inspection to deliver the findings of the above allegation. Present were the licensee, 1 fingerprint cleared assistant, 1 infant, 4 preschool children and 1 school-age child.
It was alleged that an uncleared adult was living in the home. Licensee admitted that she has allowed a family member to stay overnight on occasion. This adult would be present when children arrive in the morning.
Based on record reviews, and interviews which were conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be Substantiated. California Code of Regulations, (Title 22, Division 12 are being cited on the attached LIC9099 D. The attached Type A deficiency is being cited and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing. Exit interview conducted. Licensee was provided a copy of their appeal rights. This report must be kept available for public review for 3 years. Notice of site visit was posted at the time of the inspection and must remain posted for 30 days.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 6 of 10

Control Number 02-CC-20190220111647

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: GILFORD, MARLENE	FACILITY NUMBER: 013414711
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/04/2019 Section Cited CCR 102370(d)(1)	1 2 3 4 5 6 7	Criminal Record Clearance. All individuals subject to a criminal record review as specified in Section 1596.871 prior to working, residing or volunteering in a licensed home, shall obtain a California clearance or a criminal record exemption as required by the Department.	1 2 3 4 5 6 7	By the POC due date, licensee will submit a written statement on how she will insure no adult will be present or sleep in the home without a fingerprint clearance. All adults moving into the home must be fingerprint cleared and associated prior to the move.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by document review and interviews. Licensee allowed Lisa Concepcion to live/sleep at her facility without having a criminal record clearance. A civil penalty will be assessed today.	8 9 10 11 12 13 14	Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

LIC9099 (FAS) - (06/04)

Page: 7 of 10

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:	5621 MORSE DRIVE		TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

LIcensee hit daycare child.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

LPA Dyer and LPM Robinson conducted an unannounced complaint inspection and met with Marlene Gilford licensee, to discuss the above allegation. Present were the licensee, 1 fingerprint cleared assistant, 1 infant, 4 preschool children and 1 school-age child.
It was alleged that Licensee hit daycare child. Interviews were conducted. It was disclosed that an incident occurred where a child in care was “tapped” on her hand. Licensing regulations state that a …child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include… to be free from corporal or unusual punishment, infliction of pain..or withholding shelter, clothing, medication or aids to physical functioning.
Based on record reviews, and interviews which were conducted, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be Substantiated. California Code of Regulations, (Title 22, Division 12 are being cited on the attached LIC9099 D. The attached Type A deficiency is being cited and must be corrected by the due date. (continued)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 8 of 10

Control Number 02-CC-20190220111647

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: GILFORD, MARLENE	FACILITY NUMBER: 013414711
	VISIT DATE: 07/03/2019

NARRATIVE

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Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.
Exit interview conducted. Licensee was provided a copy of their appeal rights. This report must be kept available for public review for 3 years. Notice of site visit was posted at the time of the inspection and must remain posted for 30 days.

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

LIC9099 (FAS) - (06/04)

Page: 9 of 10

Control Number 02-CC-20190220111647

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: GILFORD, MARLENE	FACILITY NUMBER: 013414711
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/03/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 07/04/2019 Section Cited CCR 102423(a)(1-4)	1 2 3 4 5 6 7	Personal Rights. Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following..To be treated with dignity in his/her personal relationship with staff and other persons..To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature…	1 2 3 4 5 6 7	No one providing care and supervision will tap children in care. Licensee will provide a statement as to the type of discipline methods she will use from this point forward.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by interview: A child in care was “tapped” on the hand when she was misbehaving. This poses an immediate health risk to the Personal Rights of children in care.	8 9 10 11 12 13 14	Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

LIC9099 (FAS) - (06/04)

Page: 10 of 10

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:	5621 MORSE DRIVE		TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee operates out of ratio

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 3 of 10

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:	5621 MORSE DRIVE		TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child in home sexually abused

INVESTIGATION FINDINGS:

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3
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5
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7
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12
13

LPA Dyer and LPM Robinson met with Marlene Gilford for a complaint investigation regarding the above allegation. The allegation was assigned to Special Investigator Rhonda Austin of the Bureau of Investigations. During this investigation, interview were conducted.

Either 2011 or 2013 licensee failed to provide care and supervision for a daycare child. It was alleged the child was sexually abused by another person in the home.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore the results are Unsubstantiated. Exit interview conducted. This report must be kept available for public review for 3 years; Notice of Site visit must be posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 5 of 10

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:	5621 MORSE DRIVE		TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee hides day care children.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
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10
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12
13

LPA Dyer and LPM Robinson conducted an unannounced complaint inspection to deliver the findings of the above allegation. Present were the licensee, 1 fingerprint cleared assistant, 1 infant, 4 preschool children and 1 school-age child.
It was alleged that the licensee hid day care children upstairs during a licensing inspection. The upstairs area is listed as off limits. The door accessing upstairs was locked. Licensee opened the door and LPA Dyer toured the area.
There are two rooms on the second level. One room is a bedroom and the other is a storage area. The bedroom was cluttered and had stored items. The storage room was also cluttered. Interviews did not reveal enough information to determine if at any time children were allowed or hid upstairs.
Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.
Therefore, the results are Unsubstantiated. Exit interview conducted. This report must be kept available for public review for 3 years; Notice of Site visit must be posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 10

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
02/20/2019 and conducted by Evaluator Phyllis Dyer

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190220111647

FACILITY NAME:	GILFORD, MARLENE		FACILITY NUMBER:	013414711
ADMINISTRATOR:	GILFORD, MARLENE		FACILITY TYPE:	810
ADDRESS:	5621 MORSE DRIVE		TELEPHONE:	(510) 533-0516
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94605
CAPACITY:	14	CENSUS: 6	DATE:	07/03/2019
		UNANNOUNCED	TIME BEGAN:	03:15 PM
MET WITH:	Marlene Gilford		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Licensee speaks to children in inappropriate manner.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ann Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis Dyer	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2019

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 10