070212388-6-10-2019-02-CC-ARON-BCZPJ9-20190610112107

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 070212388
Report Date: 05/10/2019
Date Signed: 06/10/2019 11:19:24 AM

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
05/08/2019 and conducted by Evaluator Geneen Redmond

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20190508091107

FACILITY NAME:	WHITE DOVE SCHOOL		FACILITY NUMBER:	070212388
ADMINISTRATOR:	GIBERTI, BARBARA		FACILITY TYPE:	850
ADDRESS:	1850 SECOND STREET		TELEPHONE:	(925) 689-5067
CITY:	CONCORD	STATE: CA	ZIP CODE:	94519
CAPACITY:	41	CENSUS: 10	DATE:	05/10/2019
		UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	BARBARA GIBERTI, LICENSEE		TIME COMPLETED:	10:55 AM

ALLEGATION(S):

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Facility staff failed to keep the facility free of bed bugs.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Redmond, conducted an unannounced, Complaint investigation on 05/10/2019 at 9:45 AM. LPA met with Barbara Giberti, Licensee regarding the above listed allegation.

LPA interviewed the Licensee, staff, children and parents regarding the allegation and toured on limit areas of the facility. Based on the information LPA obtained, LPA is unable to make a determination that the bug bites occurred at the facility. Therefore, the allegation is UNSUBSTANTIATED.

A finding of unsubstantiated means, that the allegation may or may have occurred, however, there is not a preponderance of evidence to substantiate the allegation. If information is received in the future that may change the outcome of the investigation. Community Care Licensing reserves the right to reopen the complaint..

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Diane Perez	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Ann Robinson	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 05/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/10/2019

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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