013421274-12-15-2021-02-CC-LDYN-CAFNB8-20220107091843

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013421274
Report Date: 12/15/2021
Date Signed: 12/15/2021 04:13:11 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
10/20/2021 and conducted by Evaluator Arminder Singh

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20211020163923

FACILITY NAME:	CALLIRGOS, MANUELA		FACILITY NUMBER:	013421274
ADMINISTRATOR:	CALLIRGOS, MANUELA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 508-2462
CITY:	ALAMEDA	STATE: CA	ZIP CODE:	94501
CAPACITY:	14	CENSUS: 4	DATE:	12/15/2021
		UNANNOUNCED	TIME BEGAN:	02:32 PM
MET WITH:	Manuela Callirgos		TIME COMPLETED:	04:15 PM

ALLEGATION(S):

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Licensee speaks inappropriately towards daycare children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Arminder Singh conducted a complaint investigation with Licensee.

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 facillity was provided a copy of the appeal rights. An exit interview was conducted and a copy of the complaint investigation report was provided.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Arminder Singh	TELEPHONE: (510) 725-2063
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

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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