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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013419867
Report Date: 10/17/2019
Date Signed: 10/17/2019 10:52:40 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
09/11/2019 and conducted by Evaluator Phyllis Dyer
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190911102609
FACILITY NAME:BESS, MERCEDESFACILITY NUMBER:
013419867
ADMINISTRATOR:BESS, MERCEDESFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 479-1348
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY:14CENSUS: 2DATE:
10/17/2019
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Mercedes BessTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Licensee failed to transport day care children in a safe manner.
INVESTIGATION FINDINGS:
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LPA Dyer met with Licensee Mercedes Bess to deliver findings of the above allegation. Present today are the licensee, her husband and 2 day care children. Through interviews licensee admitted that she did not always have car seats or booster seats when transporting day care children.
Based on record reviews, and interviews which were conducted, 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 are being cited on the attached LIC9099 D. The attached Type A deficiency is being cited and must be corrected by the due date.
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 at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.
Exit interview conducted. Licensee was provided a copy of their appeal rights. This report must be kept available for public review for 3 years. Notice of site visit must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis DyerTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
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 4
Control Number 02-CC-20190911102609
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: BESS, MERCEDES
FACILITY NUMBER: 013419867
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/17/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/18/2019
Section Cited
CCR
102417(k)
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Operation of a Family Child Care Home. All vehicle occupants must be secured in an appropriate restraint system.
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Licensee must review the DMV rules and regulations regarding transportation of children; and complete worksheet by the POC due date.
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This requirement was not met as evidenced by licensee interview: Licensee stated that she did not always have the required number of car seats or booster seats in her vehicle when transporting children. This poses an immediate risk to the health and safety of children in care.
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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.
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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: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Phyllis DyerTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/17/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/17/2019
LIC9099 (FAS) - (06/04)
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