073406632-11-22-2019-02-CC-DPEZ-BJT8BR-20191212212245

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073406632
Report Date: 11/22/2019
Date Signed: 11/22/2019 03:32:00 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
11/15/2019 and conducted by Evaluator Geneen Redmond

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20191115102537

FACILITY NAME:	CHILD DAY SCHOOL, LLC - LAFAYETTE		FACILITY NUMBER:	073406632
ADMINISTRATOR:	MARIA C. ASUNCION		FACILITY TYPE:	850
ADDRESS:	1049 STUART STREET		TELEPHONE:	(925) 284-7092
CITY:	LAFAYETTE	STATE: CA	ZIP CODE:	94549
CAPACITY:	83	CENSUS: 68	DATE:	11/22/2019
		UNANNOUNCED	TIME BEGAN:	11:18 AM
MET WITH:	Rachel Baisch, Acting Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

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Personal Rights:

Facility staff yell at children

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Redmond, conducted an unannounced,
Complaint Investigation, follow up visit, from 11/21/19, regarding the above listed allegations. LPA met with Rachel Baisch, Acting Director during the visit.

During the visit, LPA interviewed staff and obtained and reviewed facility documentation. Based on the information obtained during the investigation regarding:

Facility staff yell at children: Interviews determine that a staff person, identified as S4 has yelled at children in an inappropriate manner.

Therefore, this allegation is - SUBSTANTIATED
CONTINUED ON LIC 9099 C/D

Substantiated

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: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 1 of 4

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
11/15/2019 and conducted by Evaluator Geneen Redmond

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20191115102537

FACILITY NAME:	CHILD DAY SCHOOL, LLC - LAFAYETTE		FACILITY NUMBER:	073406632
ADMINISTRATOR:	MARIA C. ASUNCION		FACILITY TYPE:	850
ADDRESS:	1049 STUART STREET		TELEPHONE:	(925) 284-7092
CITY:	LAFAYETTE	STATE: CA	ZIP CODE:	94549
CAPACITY:	83	CENSUS: 68	DATE:	11/22/2019
		UNANNOUNCED	TIME BEGAN:	11:18 AM
MET WITH:	Rachel Baisch, Acting Director		TIME COMPLETED:	01:00 PM

ALLEGATION(S):

1
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7
8
9

Personal Rights

A child was restrained during nap time

INVESTIGATION FINDINGS:

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3
4
5
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7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Redmond, conducted an unannounced,
Complaint Investigation, follow up visit, from 11/21/19, regarding the above listed allegations. LPA met with Rachel Baisch, Acting Director during the visit.

During the visit, LPA interviewed staff, obtained and reviewed facility documentation and reviewed physical evidence. Based on the information obtained during the investigation regarding the allegation that:

A child was restrained during nap time: Interviews and physical evidence determine that S4, a staff person, placed her leg over both legs of a child C2, while the child was taking a nap. Based on interviews and physical evidence obtained, LPA finds that the allegation is - SUBSTANTIATED - CONTINUED ON LIC 9099 C/D

Substantiated

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: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 4

Control Number 02-CC-20191115102537

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: CHILD DAY SCHOOL, LLC - LAFAYETTE	FACILITY NUMBER: 073406632
	VISIT DATE: 11/22/2019

NARRATIVE

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A finding of "substantiated" means that the preponderance of evidence standard has been met.

Plan of Correction

LPA issued a deficiency and a Plan of Correction (POC) with a due date, in order for the facility to correct the issue. See LIC 9099 D for deficiency. Facility shall also do the following:

· Facility has been issued a type A deficiency, (serious violation). Parents and or responsible parties shall be provided a copy of this report including the LIC 9099 and LIC 9099C.
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· Each parents/responsible party shall receive and sign off on the Acknowledgement of Receipt of Licensing Report form (LIC 9224) and a copy shall be placed in each child's file.

Failure to complete POC by POC due date may result in Civil Penalties of up to $100 per day, per violation.

Notice of Site Visit

LPA issued a Notice of Site Visit to signor below. Notice of Site Visit must be posted in a prominent location in facility, for 30 days, visible to parents and visitors of the facility.

Appeal Rights

LPA issued Appeal Rights to signor below. Facility has the right of appeal as discussed in the Appeal Rights.

LPA discussed Complaint Investigation Report (LIC 9099/D) with signor below.

SUPERVISOR'S NAME: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

LIC9099 (FAS) - (06/04)

Page: 2 of 4

Control Number 02-CC-20191115102537

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: CHILD DAY SCHOOL, LLC - LAFAYETTE	FACILITY NUMBER: 073406632
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 11/22/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 11/25/2019 Section Cited CCR 101223(a)(1)	1 2 3 4 5 6 7	Personal Rights: To be accorded dignity in his/her personal relationships with staff and other persons. THIS REQUIREMENT WAS NOT MET. LPA OBTAINED INFORMATION THAT S4 HAS	1 2 3 4 5 6 7	Licensee shall 1) Provide Personal Rights training to S4. Personal Rights training videos can be found online at the ccld.ca.gov website. 2) Obtain a written and signed statement from S4 that she has obtained the training
	8 9 10 11 12 13 14	YELLED AT CHILDREN IN CARE. THIS IS AN IMMEDIATE HEALTH AND SAFETY RISK TO THE CHILDREN IN CARE.	8 9 10 11 12 13 14	provide a copy to LPA by POC due date. NOTE: Failure to complete POC by due date may result in Civil Penalties of $100 per day, per violation.
Type A 11/25/2019 Section Cited CCR 101223(a)(3)	1 2 3 4 5 6 7	Personal Rights: (3) To be free from corporal or unusual punishment...(See section cited). THIS REQUIREMENT WAS NOT MET. LBA OBTAINED INFORMATION THAT S4, PLACED HER LEG OVER	1 2 3 4 5 6 7	Licensee shall 1) Provide Personal Rights training to S4. Personal Rights training videos can be found online at the ccld.ca.gov website. 2) Obtain a written and signed statement from S4 that she has obtained the training
	8 9 10 11 12 13 14	THE LEGS OF A CHILD, WHILE THE CHILD WAS TAKING A NAP. THIS IS AN IMMEDIATE RISK TO THE HEALTH AND SAFETY TO THE CHILDREN IN CARE.	8 9 10 11 12 13 14	provide a copy to LPA by POC due date. NOTE: Failure to complete POC by due date may result in Civil Penalties of $100 per day, per violation.

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: Antranette Robinson	TELEPHONE: (510) 622-2591
LICENSING EVALUATOR NAME: Geneen Redmond	TELEPHONE: (510) 873-6410
LICENSING EVALUATOR SIGNATURE:	DATE: 11/22/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2019

LIC9099 (FAS) - (06/04)

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