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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421935
Report Date: 05/12/2023
Date Signed: 05/12/2023 01:12:19 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
03/16/2023 and conducted by Evaluator Russell Haderer
COMPLAINT CONTROL NUMBER: 52-CC-20230316132347
FACILITY NAME:WILSON, DANAFACILITY NUMBER:
013421935
ADMINISTRATOR:WILSON, DANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 321-1232
CITY:FREMONTSTATE: CAZIP CODE:
94536
CAPACITY:14CENSUS: 9DATE:
05/12/2023
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:TIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
3 Personal Rights - Provider is not attending to day care children's needs, resulting in day care child sustaining a diaper rash.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/12/2023 at approximately 12:00pm, Licensing Program Analyst (LPA) Russ Haderer arrived unannounced to complete the complaint investigation for an allegation of violation of Personal Rights. Present in the home today was the licensee, and 9 children in care (3 infants; 6 two-years old) and a parent volunteer (parent of a child in care). The facility is in ratio today.

The complainant alleged that the licensee is not attending to children’s needs and as a result of being left in highchairs for long periods of time, children have had diaper rashes.
LPA investigated the complaint, conducted interviews and although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.
An exit interview was conducted with licensee Dana Wilson and a Notice of Site Visit was issued and must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Chandra Charles
LICENSING EVALUATOR NAME: Russell Haderer
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2023
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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