013418077-8-3-2023-52-CC-WNOA-CUPTZ9-20230814150958

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013418077
Report Date: 08/03/2023
Date Signed: 08/03/2023 04:04:24 PM

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 STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/08/2023 and conducted by Evaluator Melanie Otsuji

PUBLIC

COMPLAINT CONTROL NUMBER: 52-CC-20230608103826

FACILITY NAME:	POPEJOY, VICTORIA		FACILITY NUMBER:	013418077
ADMINISTRATOR:	POPEJOY, VICTORIA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 689-9721
CITY:	HAYWARD	STATE: CA	ZIP CODE:	94541
CAPACITY:	14	CENSUS: 7	DATE:	08/03/2023
		UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Chanvanny Seng		TIME COMPLETED:	04:20 PM

ALLEGATION(S):

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Licensee was engaged in a verbal altercation in the presence of daycare children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Otsuji arrived to the facility unannounced to conclude investigation into the above allegations. Present during today's visit was a fingerprint cleared assistant and 7 children (2 preschoolers and 5 school aged children).

During the course of the investigation, LPA conducted interviews, made observations and collected documentation. Based on interviews it was determined that there was/were a time(s) when Licensee may have raised her voice in the presence of daycare children. While the raising of the voice was not aimed at the children in care, it is still noted to be a personal rights violation (see attached 9099D). Based on LPAs observations and interviews which were conducted and record review, 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 & Chapter 1), are being cited on the attached LIC. 9099D.
Exit interview conducted. Appeal rights provided.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023

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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Control Number 52-CC-20230608103826

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: POPEJOY, VICTORIA	FACILITY NUMBER: 013418077
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/03/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/21/2023 Section Cited CCR 102423(a)(2)	1 2 3 4 5 6 7	Personal Rights. (a) Each child receiving services from a family child care home shall have certain rights..... These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.	1 2 3 4 5 6 7	Licensee is to review the personal rights video found at: https://ccld.childcarevideos.org/ Licensee is to submit a summary of the video and sign and date summary. Submit summary to LPA no later than 8/21/2023.
	8 9 10 11 12 13 14	-This requirement is not being met as evidence by interviews conducted which stated Licensee may have raised her voice while in the presence of children in care. This poses a potential risk to the health and safety to the 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: Wynn Norona	TELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie Otsuji	TELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:	DATE: 08/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2023

LIC9099 (FAS) - (06/04)

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