013417566-2-13-2020-02-CC-DPEZ-BMV3BR-20200319180642

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013417566
Report Date: 02/13/2020
Date Signed: 02/13/2020 10:48:32 AM

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
01/24/2020 and conducted by Evaluator Paul Peterson

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20200124133038

FACILITY NAME:	ADVANCE DAY CARE CENTER		FACILITY NUMBER:	013417566
ADMINISTRATOR:	LAM, ENG		FACILITY TYPE:	850
ADDRESS:	2236 INTERNATIONAL BLVD.		TELEPHONE:	(510) 434-9288
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94606
CAPACITY:	80	CENSUS: 50	DATE:	02/13/2020
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Eng Lam		TIME COMPLETED:	10:50 AM

ALLEGATION(S):

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Facility staff pinched daycare child.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Paul Petersen and James Sampair conducted an unannounced complaint investigation site inspection at 9:00. LPAs met with facility director Eng Lam.

Interviews were conducted. Based on the investigative findings, although the allegation may have happened or be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated at this time.

Director was provided a copy of the appeal rights and the signature on this form acknowledges receipt of these rights. An exit interview was conducted and a copy of the complaint investigation report provided. The Notice of Site visit was provided and posted and is to remain posted for 30 days from this date.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul Peterson	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/13/2020

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

LIC9099 (FAS) - (06/04)

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