073400435-11-9-2021-02-CC-SJON-C8PW4K-20211112155739

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073400435
Report Date: 11/09/2021
Date Signed: 11/09/2021 02:23:56 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
09/27/2021 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20210927132700

FACILITY NAME:	SYCAMORE CHRISTIAN PRE-SCHOOL		FACILITY NUMBER:	073400435
ADMINISTRATOR:	KINOSHITA, YOSHIMI		FACILITY TYPE:	850
ADDRESS:	1111 NAVELLIER STREET		TELEPHONE:	(510) 527-9522
CITY:	EL CERRITO	STATE: CA	ZIP CODE:	94530
CAPACITY:	30	CENSUS: 20	DATE:	11/09/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Yoshimi Kinoshita		TIME COMPLETED:	02:45 PM

ALLEGATION(S):

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Personal Rights - inappropriate interaction between staff and child

INVESTIGATION FINDINGS:

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On 11/9/21 at 1:00 PM Licensing Program Analysts (LPAs) Monica Mathur and Ashley Curry conducted an unannounced Subsequent Complaint Investigation at Sycamore Christian Preschool. LPA met with Director Yoshimi Kinoshita and explained the purpose of today’s inspection. The finding for the above allegation was delivered during the inspection. The Investigation Branch (IB) completed an initial investigation. LPA conducted a physical plant inspection, reviewed facility records and conducted interviews. Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED which means 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. No Deficiency has been cited for this allegation. Exit interview conducted with Director Yoshimi. Appeal rights were provided.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 11/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2021

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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