070213244-11-1-2019-02-CC-DPEZ-BL4W2J-20200123155424

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 070213244
Report Date: 11/01/2019
Date Signed: 11/01/2019 02:51:34 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
10/11/2019 and conducted by Evaluator Geneen Redmond

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20191011151920

FACILITY NAME:	CALVARY CHRISTIAN SCHOOL		FACILITY NUMBER:	070213244
ADMINISTRATOR:	MULLENS, AMY		FACILITY TYPE:	850
ADDRESS:	3425 CONCORD BLVD.		TELEPHONE:	(925) 682-6728
CITY:	CONCORD	STATE: CA	ZIP CODE:	94519
CAPACITY:	92	CENSUS: 36	DATE:	11/01/2019
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	MULLENS, AMY, DIRECTOR		TIME COMPLETED:	03:15 PM

ALLEGATION(S):

1
2
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5
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7
8
9

Neglect/Lack of Supervision

Day care child sustained a scratch due to hazard at facility

INVESTIGATION FINDINGS:

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2
3
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5
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9
10
11
12
13

Licensing Program Analyst (LPA) conducted an unannounced, Complaint Investigation follow up visit, regarding the above listed allegation. LPA met with Amy Mullens, Director.

A name of the child was not provided by the complainant. LPA previously conducted staff interviews. Per Director and staff, there was no knowledge of a child sustaining a scratch on the fence. Based on information obtained, LPA unable to substantiate allegation. Therefore, allegation is - UNSUBSTANTIATED.

A finding of unsubstantiated means that, 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 results are Unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 11/01/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/01/2019

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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