070212377-8-7-2019-02-CC-AEVS-BEURVU-20190808132205

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 070212377
Report Date: 08/07/2019
Date Signed: 08/07/2019 01:38:04 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
07/19/2019 and conducted by Evaluator Tasha Hackett-Alexander

COMPLAINT CONTROL NUMBER: 02-CC-20190719120731

FACILITY NAME:	YMCA OF THE EAST BAY Y-KIDS STEWART		FACILITY NUMBER:	070212377
ADMINISTRATOR:	COVEY, PAULA		FACILITY TYPE:	840
ADDRESS:	2040 HOKE DRIVE		TELEPHONE:	(510) 262-6588
CITY:	PINOLE	STATE: CA	ZIP CODE:	94564
CAPACITY:	62	CENSUS: 40	DATE:	08/07/2019
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	TYLER BIRSS		TIME COMPLETED:	01:30 PM

ALLEGATION(S):

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9

NEGLECT/LACK OF SUPERVISION- staff failed to provide adequate supervision resulting in child escaping

INVESTIGATION FINDINGS:

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LPA TASHA ALEXANDER MET WITH CENTER DIRECTOR TYLER BIRSS TO DELIVER THE FINDINGS TO THE ABOVE COMPLAINT ALLEGATION.
UPON ARRIVAL THERE ARE 40 CHILDREN PRESENT ALONG WITH 5 ON THE PLAY YARD.
DURING THIS ANALYST'S LAST VISIT, INTERVIEWS WERE CONDUCTED WITH STAFF AND CHILDREN, FILES WERE REVIEWED AND THE FACILITY GROUNDS WERE TOURED. FURTHER INVESTIGATION HAS BEEN CONDUCTED AND IT HAS BEEN FOUND THAT AT LEAST ONE SCHOOL AGE CHILD, IN FRUSTRATION HAS WALKED AWAY FROM "THE GROUP" OR OUT OF THE CLASS ROOM ON MULTIPLE OCCASIONS. DURING THESE TIMES, STAFF WAS PRESENT AND WITNESSED THE CHILD LEAVING AND WAS ABLE TO FOLLOW AND BRING THE CHILD BACK. ALTHOUGH, STAFF HAS WITNESSED THESE INCIDENTS AND WAS PRESENT, THEY HAVE FAILED TO MEET THE CHILD'S NEEDS.
BASED ON LPAs OBSERVATIONS AND INTERVIEWS WHICH WERE CONDUCTED AND RECORD REVIEWS, THE PREPONDERANCE OF EVICENCE STANDARD HAS BEEN MET, THEREFORE THE ABOVE ALLEGATION IS FOUND TO BE SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), ARE BEING CITED ON THE ATTACHED LIC. 9099D.

This report must be available for public review for 3 years. An exit interview was conducted. A notice of site visit was posted.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

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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Control Number 02-CC-20190719120731

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: YMCA OF THE EAST BAY Y-KIDS STEWART	FACILITY NUMBER: 070212377
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/07/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/28/2019 Section Cited CCR 101229(a)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. REQUIREMENT WAS NOT MET: THE FACILITY FAILED TO MEET A CHILD'S NEEDS WHEN A CHILD WAS ALLOWED TO WALK AWAY FROM THE FACILITY.	1 2 3 4 5 6 7	STAFF WILL DEVELOP A BEHAVIORAL PLAN TO GIVE CHILDREN AN ALTENATIVE TO LEAVING THE GROUP OR CLASSROOM WHEN THEY BECOME FRUSTRATED. THE PLAN SHALL BE SUBMITTED TO COMMUNITY CARE LICENSING BY 8/28/19.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Wynn Norona	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Tasha Hackett-Alexander	TELEPHONE: (510) 622-2618
LICENSING EVALUATOR SIGNATURE:	DATE: 08/07/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/07/2019

LIC9099 (FAS) - (06/04)

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