<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422457
Report Date: 11/03/2021
Date Signed: 11/03/2021 02:11:22 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 STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/12/2021 and conducted by Evaluator Melanie Otsuji
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20210812101947
FACILITY NAME:LITTLE STEAMERSFACILITY NUMBER:
013422457
ADMINISTRATOR:FIGONE, CHERRYLFACILITY TYPE:
850
ADDRESS:43531 MISSION BLVD.TELEPHONE:
(510) 557-3337
CITY:FREMONTSTATE: CAZIP CODE:
94539
CAPACITY:25CENSUS: 0DATE:
11/03/2021
UNANNOUNCEDTIME BEGAN:
11:54 AM
MET WITH:Joni JenTIME COMPLETED:
12:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Facility staff did not provide visual supervision for child in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**THIS REPORT WAS DRAFTED AND DELIVERED ELECTRONICALLY AS FACILITY IS CURRENTLY CLOSED UNTIL JANUARY 2022.**

Licensing Program Analyst (LPA) Melanie Otsuji arrived to the facility on 10/22/2021 to deliver findings of complaint. Upon arrival, LPA noted that facility was closed. LPA waited approximately 30 minutes before leaving to ensure facility was indeed closed. LPA left a message with facility. LPA received a phone call a few days later from Licensee, Joni Jen. Ms. Jen stated that she is currently out of the country and facility is closed until at least January 2022. During the course of the investigation LPA conducted interviews and collected documenation. Based on interviews LPA received conflicting information. Based on interviews conducted, the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore, the allegation is UNSUBSTANTIATED.
A notice of site visit was given and must remain posted for 30 days.
Appeal Rights were given and discussed. An exit interview was conducted.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2021
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 2