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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013419414
Report Date: 05/23/2019
Date Signed: 05/23/2019 03:15:51 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
05/16/2019 and conducted by Evaluator Paul Peterson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190516110728
FACILITY NAME:OAKLAND GARDEN SCHOOL, INC.FACILITY NUMBER:
013419414
ADMINISTRATOR:LUIS VILLACRECESFACILITY TYPE:
850
ADDRESS:4012 MAYBELLE AVENUETELEPHONE:
(510) 531-4800
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:72CENSUS: 64DATE:
05/23/2019
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Luis VillacrecesTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility staff left daycare child outside unsupervised.

INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced complaint investigation site inspection for this facility on 05/23/19 at 0910. LPA met with director, Luis Villacreces. Also present were facility owner, Tae Gyungha, 64 preschool age children in care and nine additional teaching staff. Based on information gathered through interviews and a review of the facility records, the preponderance of evidence standard has been met and LPA veified that a child in care was left outside without staff supervision when the other children and staff had transitioned in doors. Therefore, the above allegation is found to be substantiated. California Code of Regulations, Tittle 22, is being cited on the attached LIC 9099D for a Type A violation. 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 in the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224).
An exit interview was conducted with the facility director and a plan of correction was discussed. Appeal rights were given and explained. AB633 notification was provided. A printed copy of this report as well as a notice of site visit was provided and are to remain posted at this facility for a period of 30 days..
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
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 3
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
05/16/2019 and conducted by Evaluator Paul Peterson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190516110728

FACILITY NAME:OAKLAND GARDEN SCHOOL, INC.FACILITY NUMBER:
013419414
ADMINISTRATOR:LUIS VILLACRECESFACILITY TYPE:
850
ADDRESS:4012 MAYBELLE AVENUETELEPHONE:
(510) 531-4800
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:72CENSUS: 64DATE:
05/23/2019
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Luis VillacrecesTIME COMPLETED:
03:15 PM
ALLEGATION(S):
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Facility was out of ratio.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced complaint investigation site inspection for this facility on 05/23/19 at 0910. LPA met with director, Luis Villacreces. Also present were facility owner, Tae Gyungha, 64 preschool age children in care and nine additional teaching staff. 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.

The facility director was provided a copy of the appeal 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 NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
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 3
Control Number 02-CC-20190516110728
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: OAKLAND GARDEN SCHOOL, INC.
FACILITY NUMBER: 013419414
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/23/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
05/24/2019
Section Cited
CCR
101229(a)(1)
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101229(a)(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. This facility was not in compliance with this requirement as evidenced by the vieried incident of child
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This facility agrees to ensure that all children in care will be supervised at all times from this point forward. In addition, the facility will submit by 06/07/19 an updated training/protocol signed by all staff describing the facility policy to ensure safe transitions into and out of the facility at all times. This is a zero tolerance violation. An
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C1 remaining outside on the playground area alone for several minutes after all staff and the other children had reentered the facility posing an immediate risk to the health and safety of the child.
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immediate $500 is assessed today and $100 per day will be assessed until corrected. Subsequent zero tolerance violations are $1000 immediate civil penalty and $100 per day will be assessed until corrected
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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 NoronaTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/23/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/23/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 3