013418175-8-9-2022-02-CC-LDYN-CH8BMW-20220812011236

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013418175
Report Date: 08/09/2022
Date Signed: 08/09/2022 03:21:10 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, SUITE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/12/2022 and conducted by Evaluator Arminder Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20220512154013

FACILITY NAME:	FUZZY CATERPILLAR		FACILITY NUMBER:	013418175
ADMINISTRATOR:	RISSE, TALI		FACILITY TYPE:	850
ADDRESS:	1510-1504A ENCINAL AVENUE		TELEPHONE:	(510) 205-0985
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94501
CAPACITY:	66	CENSUS:	DATE:	08/09/2022
		UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:			TIME COMPLETED:	03:20 PM

ALLEGATION(S):

1
2
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7
8
9

Neglect/Lack of Supervision

INVESTIGATION FINDINGS:

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2
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13

On 08/09/2022 LPA Singh met with Director, Tali Risse to deliver the findings for the above allegation. It was alleged that Day care facility: Neglect/Lack of Supervision due to a child's inappropriate interaction with another child. LPA Singh conducted interviews with Director and multiple staff members during the coarse of this investigation. Children were being supervised by staff member but the staff member was unable to prevent the child from inappropriately interacting with the other child in time.

Based on LPAs investigative findings, the preponderance of evidence standard has been met. Licensee's neglect/level of supervision did not meet the needs of the child in care. 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 facility was provided a copy of the appeal rights. An exit interview was conducted and a copy of the complaint investigation report was provided.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

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 02-CC-20220512154013

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: FUZZY CATERPILLAR	FACILITY NUMBER: 013418175
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/09/2022

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/09/2022 Section Cited CCR 101229(A)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.	1 2 3 4 5 6 7	By 09/09/2019, Director will submit a written plan of action on ways facility will ensure visual supervision of children in care at all times.
	8 9 10 11 12 13 14	This requirement was not met as evidence: child was able to interact with another child inappropriately.	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: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 08/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/09/2022

LIC9099 (FAS) - (06/04)

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