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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013420536
Report Date: 02/09/2023
Date Signed: 02/09/2023 02:46:23 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
01/25/2023 and conducted by Evaluator Christina Uribe
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20230125095120
FACILITY NAME:LITTLE FLOWERS LEARNING CENTERFACILITY NUMBER:
013420536
ADMINISTRATOR:SUCHETA ROYFACILITY TYPE:
850
ADDRESS:5801 JARVIS AVETELEPHONE:
(510) 794-8350
CITY:NEWARKSTATE: CAZIP CODE:
94560
CAPACITY:41CENSUS: 13DATE:
02/09/2023
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Maggie BaltazarTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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Day care child wandered from facility unattended
INVESTIGATION FINDINGS:
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On 02/09/2023 at 12:30pm, Licensing Program Analyst (LPA) Christina Uribe conducted an unannounced visit for the purpose of investigating a complaint for the above allegation of lack of supervision and met with facility representative, Maggie Baltazar. At the time of the visit there are 13 children and 3 staff present.

Based on LPA’s documentation and interviews which were conducted and recorded, the preponderance of evidence standard has been met, therefore the above allegation of day care child wandered from facility unattended is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division12, Chapter 1, Section 101229(a)(1), is being cited as a Type A Violation on the attached LIC 9099D form. Additionally, an immediate civil penalty of $500.00 is being assessed today due to this violation on the attached LIC 421IM
form.

Page 1 of 2 ***Continued on LIC 9099C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023
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
Control Number 52-CC-20230125095120
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: LITTLE FLOWERS LEARNING CENTER
FACILITY NUMBER: 013420536
VISIT DATE: 02/09/2023
NARRATIVE
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LPA Uribe informed facility representative, Maggie Baltazar, that this report dated 02/09/2023 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Uribe informed the licensee to provide a copy of this licensing report dated 02/09/2023 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

A notice of site visit was given and must remain posted for 30 days. Copy of appeal rights and report was given. Exit interview was conducted with facility representative, Maggie Baltazar.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 52-CC-20230125095120
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: LITTLE FLOWERS LEARNING CENTER
FACILITY NUMBER: 013420536
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/10/2023
Section Cited
CCR
101229(a)(1)
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Title 22, Division 12, Chapter 1, Section 101229(a)(1) No child(ren) shall be left without the supervision of a teacher at any time. Supervision shall include visual supervision.

This regulation is not met as evidenced by:
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Since this incident, the facility has implemented several protocols to enhance safety and supervision to children in care. Licensee will create a written statement explaining all new and existing safety protocols to ensure that each child will be adequately supervised at all times.
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The facility did not ensure proper supervision resulting in a child walking out of the facility and into the parking lot without supervision which poses an immediate health, safety, or personal rights risk to children in care.
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Licensee will have each staff member sign this written statement as an acknowlledgement that they have received training on these protocols and understand their responsibility to the supervision of children in care. Statement will be emailed to LPA Uribe no later than 6pm on 02/10/23.
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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.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Christina Uribe
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3