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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421000
Report Date: 10/02/2019
Date Signed: 10/02/2019 01:48:24 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
07/02/2019 and conducted by Evaluator Caroline Colson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190702140403
FACILITY NAME:HEARNE, KARENFACILITY NUMBER:
013421000
ADMINISTRATOR:HEARNE, KARENFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 434-1080
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY:14CENSUS: 7DATE:
10/02/2019
UNANNOUNCEDTIME BEGAN:
09:46 AM
MET WITH:Karen HearneTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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9
Personal Rights - Licensee denied child food.
INVESTIGATION FINDINGS:
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Licensing Program Analyst Caroline Colson met with Karen Hearne, licensee and assistant Brianna Byrant for an unannounced complaint investigation at 9:46 AM. There are two (2) infants and five (5) preschool children. During the course of the investigation, it was determined that the licensee works at nights. Licensee was not available to serve the day care child who arrived late for breakfast. Assistant tried to contact the licensee in order to obtain permission to feed the child breakfast. The assistant was unable to obtain permission from the licensee to feed the child. Therefore, the child was denied breakfast until the next meal. Based on LPA's interviews which were conducted and a record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, 102423 (a) is being cited on the attached LIC 9099 D.

The attached type A deficiency is being cited today 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 (LIC 9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2019
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 5
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
07/02/2019 and conducted by Evaluator Caroline Colson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190702140403

FACILITY NAME:HEARNE, KARENFACILITY NUMBER:
013421000
ADMINISTRATOR:HEARNE, KARENFACILITY TYPE:
810
ADDRESS:3102 STUART ST.TELEPHONE:
(510) 434-1080
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY:14CENSUS: 7DATE:
10/02/2019
UNANNOUNCEDTIME BEGAN:
09:46 AM
MET WITH:Karen HearneTIME COMPLETED:
02:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Reporting Requirements - Child sustained injury while in care.
INVESTIGATION FINDINGS:
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5
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Licensing Program Analyst Caroline Colson met with Karen Hearne, licensee and assistant Brianna Bryant for an unannounced complaint investigation at 9:46 AM. There are two (2) infants and five (5) preschool children. During the course of the investigation, it was determined that a child fell at play. Licensee and Assistant weren't aware that a child was injured. When the child's authorized representative arrived, seen cut on left eye and took child to the emergency room. Licensee was informed that the child went to emergency room for medical treatment. However, the incident was never reported to Community Care Licensing. Based on LPA's interviews which were conducted and a record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, 102416.2 (b) is being cited on the attached LIC 9099 D.

The attached type B deficiency is being cited today and must be corrected by the due date. Notice of site visit was posted at the time of the inspection and must be posted for 30 days. An exit interview was conducted. Appeal rights were given and discussed. This report must be available for public review for 3 years.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2019
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 5
Control Number 02-CC-20190702140403
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: HEARNE, KAREN
FACILITY NUMBER: 013421000
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/18/2019
Section Cited
CCR
102416.2(b)1
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7
Reporting Requirements
Medical treatment means treatment by a medical professional, as defined in Section 101152(m).

Licensee didn't report an unusual incident to CCL.
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7
Licensee will review the video for Reporting Requirements on the department's website at www.ccld.ca.gov. A written summary will be sent to CCL.
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9
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This requirement was not met as evidenced by document review and licensee interview. This poses a potential health and safety risk to children in care.
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9
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14
Failure to correct will result in a $100.00 per day civil penalty until corrected. Repeat violations are 250.00 per violation and $100.00 per day until corrected.
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7
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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: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2019
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 02-CC-20190702140403
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: HEARNE, KAREN
FACILITY NUMBER: 013421000
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/02/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/09/2019
Section Cited
CCR
102423(a)(4)
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2
3
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5
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7
Personal Rights
To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
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Licensee will review the video for personal rights on the department's website www.ccld.ca.gov. A written summary will be sent to CCL.
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14
A child was denied a meal. This requirement was not met as evidenced by document review and licensee interview. This poses an immediately health and safety risk to children in care.
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14
Failure to correct will result in a $100.00 per day civil penalty until corrected. Repeat violations are 250.00 per violation and $100.00 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: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2019
LIC9099 (FAS) - (06/04)
Page: 4 of 5
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
07/02/2019 and conducted by Evaluator Caroline Colson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20190702140403

FACILITY NAME:HEARNE, KARENFACILITY NUMBER:
013421000
ADMINISTRATOR:HEARNE, KARENFACILITY TYPE:
810
ADDRESS:3102 STUART ST.TELEPHONE:
(510) 434-1080
CITY:OAKLANDSTATE: CAZIP CODE:
94602
CAPACITY:14CENSUS: 7DATE:
10/02/2019
UNANNOUNCEDTIME BEGAN:
09:46 AM
MET WITH:Karen HearneTIME COMPLETED:
02:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights - Licensee yells in front of children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst Caroline Colson met with Karen Hearne, licensee and assistant Brianna Byrant for an unannounced complaint investigation at 9:46 AM. There are two (2) infants and five (5) preschool children. Interviews were conducted. There was no corroboration that the licensee yells at or in front of children. Licensee does have a naturally loud voice and can elevate her voice when redirecting children. Based on the investigative findings, it cannot be proven or disproven whether the licensee yells at or in front of children in care. Although the allegation may have happened or is valid, there is not a perponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated.

Notice of site visit was posted at the time of the inspection and must be posted for 30 days. An exit interview was conducted. Appeals rights were given and discussed. This report must be available for public review for 3 years.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ann RobinsonTELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Caroline ColsonTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 10/02/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/02/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 5