013423298-12-9-2019-02-CC-DPEZ-BL5R86-20200124114726

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013423298
Report Date: 12/09/2019
Date Signed: 12/09/2019 01:06:19 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
12/02/2019 and conducted by Evaluator Susan Neeson

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20191202103143

FACILITY NAME:	HART, LAWRENCE		FACILITY NUMBER:	013423298
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY:	8	CENSUS: 1	DATE:	12/09/2019
		UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Lawrence Hart		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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Uncleared adult working at facility

INVESTIGATION FINDINGS:

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Licensing Program Analyst Susan Neeson met with Lawrence Hart, licensee, regarding the above allegation for an unannounced complaint investigation at 8:30 AM. An interview was conducted. There is one day care childre present during the investigation. Also present are two adult males, one who is fingerprint clear and the other who is visiting for a short while. A roster was requested. Based on the investigative findings, it cannot be proven or disproven whether an uncleared person has been working at the facility. It was not possible to obtain additional information from the complainant. Although 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.

Appeal Rights were discussed.

An exit interview was given.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Susan Neeson	TELEPHONE: (510)622-2630
LICENSING EVALUATOR SIGNATURE:	DATE: 12/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2019

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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