013420964-1-20-2021-02-CC-MMEA-BXU4BM-20210201175747

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013420964
Report Date: 01/20/2021
Date Signed: 01/20/2021 03:01:44 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
12/14/2020 and conducted by Evaluator Catherine Fernandes

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20201214153525

FACILITY NAME:	BERKELEY YMCA HEAD START - EMERYVILLE MARINA		FACILITY NUMBER:	013420964
ADMINISTRATOR:	WILLIAMS, ROCHELLE LA'RUE		FACILITY TYPE:	830
ADDRESS:	1275 - 61ST ST		TELEPHONE:	(510) 601-8674
CITY:	EMERYVILLE	STATE: CA	ZIP CODE:	94608
CAPACITY:	40	CENSUS: 0	DATE:	01/20/2021
		ANNOUNCED	TIME BEGAN:	01:54 PM
MET WITH:	Rochelle Williams		TIME COMPLETED:	03:01 PM

ALLEGATION(S):

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Facility heater is broken.

INVESTIGATION FINDINGS:

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On January 20, 2021, at 1:54PM Licensing Program Analyst (LPA) Catherine Fernandes conducted a tele-visit with Director Rochelle Williams to deliver the findings to the above complaint allegation. Due to COVID-19 the inspection was via telephone. No children were in care during todays inspection.

Based on conformation from Director Williams the facility heater was not blowing hot air to some of the classrooms and it needed a certain part to be able to repair it. Director Williams stated that as soon as she was aware a work order was submitted and that in the meantime the center provided space heaters. Witnesses stated that the heater was broken for about a week, therefore the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. Title 22, is being cited on the attached LIC. 9099D.

Appeal Rights were discussed
An exit interview was conducted
Report and Appeal Rights will be emailed and mailed.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2021

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-20201214153525

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: BERKELEY YMCA HEAD START - EMERYVILLE MARINA	FACILITY NUMBER: 013420964
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/20/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 01/29/2021 Section Cited CCR 101238(a)	1 2 3 4 5 6 7	101238(a)Buildings and Grounds- The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. The requirements have not been met as evidenced by:	1 2 3 4 5 6 7	Director is to submit the proof of a complete work order to CCLD by proof of correction date.
	8 9 10 11 12 13 14	Based on conformation from the Director the heater was not working properly, which can be a potential health risk to 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: Mayla Mendoza	TELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine Fernandes	TELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:	DATE: 01/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/20/2021

LIC9099 (FAS) - (06/04)

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