070206884-9-14-2021-02-CC-LDYN-C7F4RH-20211002191955

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 070206884
Report Date: 09/14/2021
Date Signed: 09/14/2021 01:46:25 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
07/07/2021 and conducted by Evaluator Lakeisha Chew

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20210707131818

FACILITY NAME:	LARSON'S CHILDREN CENTER		FACILITY NUMBER:	070206884
ADMINISTRATOR:	STEPHANIE MONTAGUE		FACILITY TYPE:	850
ADDRESS:	920 DIABLO ROAD		TELEPHONE:	(925) 837-4238
CITY:	DANVILLE	STATE: CA	ZIP CODE:	94526
CAPACITY:	45	CENSUS: 39	DATE:	09/14/2021
		UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	STEPHANIE MONTAGUE		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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PERSONAL RIGHTS - Facility not following COVID-19 mask Guidance

INVESTIGATION FINDINGS:

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At 8:40 AM Licensing Program Analyst (LPA) L. Chew and Licensing Program Manager (LPM) L. Dyson arrived at facility and began to make observations of children being dropped off. LPA and LPM entered facility at 9:17 AM to conduct an unannounced complaint investigation regards to the above allegation. LPA and LPM continue to conduct observations after admission into facility. It was reported that the facility is not following COVID-19 mask Guidance. LPA and LPM met with Administrator, STEPHANIE MONTAGUE. Administrator guided LPA and LPM on tour of facility inside and out. Present during inspection were 39 preschool-age children in care and 8 staff members which includes Administrator. LPA and LPM observed during the inspection children indoors were not wearing face masks as required by the CA Department of Public Health as mandated as a necessary precaution to prevent the spread of COVID-19 for children 2years of age and older. Documents was obtained for file and reviewed during the course of the investigation and an interview was conducted with Administrator. Please See LIC 9099C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) -69-0243
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

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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Control Number 02-CC-20210707131818

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LARSON'S CHILDREN CENTER	FACILITY NUMBER: 070206884
	VISIT DATE: 09/14/2021

NARRATIVE

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Based on the LPA and LPM observations which were conducted the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations (CCR), (Title 22, Division 12 & Chapter 1 Article 6 Section 101223(a)(2) type B deficiency is being cited today on the attached LIC 9099D.
An exit interview was conducted. Appeal rights were given and discussed. Notice of Site visit was provided and must remain posted for 30 days. This report must be available for public review for 3 years.

Please See LIC 9099 D for deficiency

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) -69-0243
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20210707131818

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: LARSON'S CHILDREN CENTER	FACILITY NUMBER: 070206884
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/14/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/14/2021 Section Cited CCR 101223(a)(2)	1 2 3 4 5 6 7	101223(a)(2) (a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.This requirement has not been met as evidence by	1 2 3 4 5 6 7	Administartor will ensure children in care 2 years and older will wear face mask inside facility as required by CA Dept. of Public Health. A Facility Mask Policy will be provided to CCL by COB Wednesday, 9/15/2021 for children in care 2 years and older..
	8 9 10 11 12 13 14	LPA and LPM observations during the course of the inspection: Children in care inside the facility were not wearing face masks as required by the CA Department of Public Health mandated as a necessary precaution to prevent the spread of COVID-19 for children 2years of age and older	8 9 10 11 12 13 14
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Loretta Dyson	TELEPHONE: (510) -69-0243
LICENSING EVALUATOR NAME: Lakeisha Chew	TELEPHONE: (510) 566-5850
LICENSING EVALUATOR SIGNATURE:	DATE: 09/14/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/14/2021

LIC9099 (FAS) - (06/04)

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