013416167-6-18-2024-02-CC-SJON-D7HRPH-20240725131154

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013416167
Report Date: 06/18/2024
Date Signed: 06/18/2024 12:37:42 PM

Unsubstantiated

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
06/14/2024 and conducted by Evaluator Christina Watts

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240614152826

FACILITY NAME:	COLEMAN, BEVERLY		FACILITY NUMBER:	013416167
ADMINISTRATOR:	COLEMAN, BEVERLY		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 978-0744
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94603
CAPACITY:	14	CENSUS: 3	DATE:	06/18/2024
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Beverly Coleman		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility is in disrepair

INVESTIGATION FINDINGS:

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On 06/18/2024 at 9:50 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced Initial Complaint Investigation at Beverly Coleman's large family child care home. LPA met with licensee Beverly Coleman and explained the purpose of today’s inspection. During today's inspection, there were 3 preschool children in care. Also present during inspection was licensee's 3 minor grandchildren ( 1 preschooler and 2 infants), licensee's 13 year old grandchild and licensee's adult grandchild who is licensee assistant. The finding for the above allegation was delivered during the inspection. Complainant alleges that Facility is in disrepair. During the course of the investigation completed a physical plant inspection, reviewed facility records and conducted interviews. It was determined that the area in disrepair is an off limits area which is inaccessible to children in care. Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED which means 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. No Deficiency has been cited for this allegation. Exit interview conducted with Beverly Coleman. Appeal rights were provided. A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECTIVE DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

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

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
06/14/2024 and conducted by Evaluator Christina Watts

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240614152826

FACILITY NAME:	COLEMAN, BEVERLY		FACILITY NUMBER:	013416167
ADMINISTRATOR:	COLEMAN, BEVERLY		FACILITY TYPE:	810
ADDRESS:	10751 PIPPIN STREET		TELEPHONE:	(510) 978-0744
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94603
CAPACITY:	14	CENSUS: 3	DATE:	06/18/2024
		UNANNOUNCED	TIME BEGAN:	09:50 AM
MET WITH:	Beverly Coleman		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Facility is malodorous

INVESTIGATION FINDINGS:

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On 06/18/2024 at 9:50 AM, Licensing Program Analyst (LPA) Christina Watts conducted an unannounced Initial Complaint Investigation at Beverly Coleman's large family child care home. LPA met with licensee Beverly Coleman and explained the purpose of today’s inspection. During today's inspection, there were 3 preschool children in care. Also present during inspection was licensee's 3 minor children ( 1 preschooler and 2 infants), licensee's 13 year old grandchild and licensee's adult grandchild who is licensee assistant.The finding for the above allegation was delivered during the inspection. Complainant alleges Facility is malodorous. During the course of the investigation, LPA inspected the facility, reviewed records and conducted interviews. As LPA was walking into the front yard, LPA did smell an odor of animal urine. Licensee stated they do have pets that live in the home however licensee was unable to clean the front yard today when they normally clean the front yard. Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page. Exit interview conducted with Beverly Coleman. A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECTIVE DAYS.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

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 4

Control Number 02-CC-20240614152826

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: COLEMAN, BEVERLY	FACILITY NUMBER: 013416167
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/18/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 06/21/2024 Section Cited CCR 102417(b)	1 2 3 4 5 6 7	102417 Operation of a Family Child Care Home (b) The home shall be kept clean and orderly, with heating and ventilation for safety and comfort. This requirement has not been met as evidenced by:	1 2 3 4 5 6 7	By 06/18/2024, Licensee stated they will submit a written statement on how facility will come back into compliance. 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.
	8 9 10 11 12 13 14	Based observation and interview, the licensee did not comply with the section cited above when facility was observed to smell like animal urine in an on limits area which poses an potential risk to the health, safety or personal rights of children in care.	8 9 10 11 12 13 14
	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: Sherelle Johnson	TELEPHONE: (510) 421-3587
LICENSING EVALUATOR NAME: Christina Watts	TELEPHONE: (510) 246-1797
LICENSING EVALUATOR SIGNATURE:	DATE: 06/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/18/2024

LIC9099 (FAS) - (06/04)

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