073406632-3-12-2020-02-CC-SJON-BPRV8B-20200519161223

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073406632
Report Date: 03/12/2020
Date Signed: 03/12/2020 03:29:43 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
03/05/2020 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20200305161450

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: 54	DATE:	03/12/2020
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Rachel Baisch		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Daycare child was left unattended

INVESTIGATION FINDINGS:

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On 03/12/20 at 10:00 AM Licensing Program Analyst (LPA) Monica Mathur conducted an Unannounced 10 Day Initial Complaint Investigation at Child Day School LLC - Lafayette. LPA met with Acting Director, Rachel Baisch and explained the purpose of today's investigation. During the course of the investigation, LPA inspected the Preschool, observed teacher children interactions, conducted interviews, reviewed records and obtained relevant documents.

Complainant alleges: Daycare child was left unattended. Based on information obtained, it was determined that on 03/04/20 during transition time, there was an Absence of Supervision when Child 1 (C1) was left unattended in Bathroom A for approximately several minutes without visual and direct supervision. After school personnel realized the incident had occurred, C1 was attended to and escorted back to the classroom.

Due to absence of supervision being zero tolerance, and posing an immediate risk to the health and safety of children, a Type A deficency is cited during today's inspection and Immediate Civil Penalty of $500 is issued.

CONTINUED ON NEXT PAGE 9099-C

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

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-20200305161450

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: 03/12/2020

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 03/13/2020 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care & Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	By POC Due Date 03/13/20 Acting Director Rachel agreed to submit to CCL a written plan on how Center will ensure visual and direct supervision is provided at all times especially during transitions.
	8 9 10 11 12 13 14	Per LPA's inspection and interviews, it is determined on 03/04/20 there was Absence of Supervision when Child 1 (C1) was left unattended in Bathroom A for several minutes without visual and direct supervision. This poses an immediate risk to the health and safety of children in care. An Immediate Civil Penalty of $500 is assessed.	8 9 10 11 12 13 14	By 04/10/20 Rachel agreed to conduct an All Staff Training where Care & Supervision will be discussed. A copy of Agenda and staff attendance to be provided to CCL by 04/10/20.
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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: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

LIC9099 (FAS) - (06/04)

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Control Number 02-CC-20200305161450

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: 03/12/2020

NARRATIVE

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Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page.

At 2:25 PM Exit interview was conducted, this report, the citation, civil penalties, plan of correction, and appeal rights were discussed with the Acting Director, Rachel. Requirements of AB633 were also provided and discussed.

Due to the issuance of a Type A Citation during today's inspection, a copy of this Licensing Report must be POSTED in the facility and PROVIDED to each existing parent by the end of today or next day child is in care. Report also has to be provided to the parent of children who are enrolled over the next 12 months. In addition, a copy of the LIC 9224 Acknowledgement of Receipt of Licensing Reports was provided and must be signed by each parent and kept in each child's file

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR NAME: Monica Mathur	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 03/12/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/12/2020

LIC9099 (FAS) - (06/04)

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