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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073406632
Report Date: 05/29/2020
Date Signed: 10/06/2020 12:52:33 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
02/21/2020 and conducted by Evaluator Diana Campos
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20200221140501
FACILITY NAME:CHILD DAY SCHOOL, LLC - LAFAYETTEFACILITY NUMBER:
073406632
ADMINISTRATOR:MARIA C. ASUNCIONFACILITY TYPE:
850
ADDRESS:1049 STUART STREETTELEPHONE:
(925) 284-7092
CITY:LAFAYETTESTATE: CAZIP CODE:
94549
CAPACITY:83CENSUS: DATE:
05/29/2020
UNANNOUNCEDTIME BEGAN:
02:15 PM
MET WITH:Maria C. AsuncionTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Staff changing diapers without changing gloves for each child.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Diana Campos spoke to Center Director Maria C. Asuncion to conclude the complaint investigation regarding the above allegation. Due to the COVID-19 shelter in place order issued by the Governor of California, the complaint findings were delivered via telephone. Facility remains closed due to shelter in place order.
During the course of the investigation, telephone interviews were conducted, and documents were reviewed. It has been determined based on staff interviews that children's diapers were being changed outside on more than one occasion.
Based on interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, Title 22 is being cited on the attached LIC 9099D. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in additional civil penalties.
***Continued on LIC 9099C...
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana CamposTELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2020
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 3
Control Number 02-CC-20200221140501
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: 05/29/2020
NARRATIVE
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 Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in additional civil penalties.

The attached type B violation is cited today and must be corrected by the due date.

Exit interview conducted with Ms. Asuncion. A copy of this report and appeal rights were provided through email, and Ms. Asuncion agrees to sign the report and return to LPA.
SUPERVISOR'S NAME: Sherelle JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana CamposTELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2020
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20200221140501
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: 05/29/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/30/2020
Section Cited
CCR
101223(1)(2)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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Designated staff will radio management in the event that no other staff is available to cover for them during diaper changing.
Director states staff will write a summary on safe and appropriate diapering procedures.
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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 JohnsonTELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Diana CamposTELEPHONE: (510) 873-6322
LICENSING EVALUATOR SIGNATURE:

DATE: 05/29/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/29/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3