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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013423434
Report Date: 05/04/2022
Date Signed: 05/04/2022 12:20:14 PM

Substantiated


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
03/16/2022 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20220316141817
FACILITY NAME:JUNG, LINDAFACILITY NUMBER:
013423434
ADMINISTRATOR:MODLIN, LINDAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(925) 750-7680
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY:14CENSUS: 10DATE:
05/04/2022
UNANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:TIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of Supervison
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/04/22 at 11:00 AM Licensing Program Analyst (LPA) Lorraine Dacanay Breaux and Elimika Woods conducted a Complaint Investigation at Family Child Care Home, and met with Licensee Linda Jung. During today's visit there were 10 children in care and 2 staff. During the course of the investigation, the Department inspected the facility, reviewed records, and conducted interviews. It was confirmed per licensee and staff that a child did in fact run back to the facility while on a walk to the local park, neighbor held child until staff was in view and child immediately went to staff. Police were notified, and report provided to CCLD.

The allegation that the licensee had Lack of Supervision/Neglect has been SUBSTANTIATED. Based on the observations, records and interviews which were obtained throughout the investigation, the preponderance of evidence standard has been met, Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

LPAs discussed with licensee the seriousness of the substantiated finding for this complaint. Exit interview was conducted, where this report, the deficiency, plan of correction, and appeal rights were discussed with Licensee, Linda Jung.

A notice of site visit was given and must remain posted for 30 days.




Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Chandra CharlesTELEPHONE: (510) 286-0966
LICENSING EVALUATOR NAME: Lorraine Dacanay-BreauxTELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:

DATE: 05/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/04/2022
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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