073406634-12-15-2021-52-CC-JJAG-CBEPDU-20220207101404

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073406634
Report Date: 12/15/2021
Date Signed: 12/15/2021 01:27:58 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 STE 1102
OAKLAND, CA 94612

This is an official report of an unannounced visit/investigation of a complaint received in our office on
12/13/2021 and conducted by Evaluator Julia Placencia

COMPLAINT CONTROL NUMBER: 52-CC-20211213111915

FACILITY NAME:	CHILD DAY SCHOOL, LLC - SAN RAMON		FACILITY NUMBER:	073406634
ADMINISTRATOR:	VALDES, RUTH		FACILITY TYPE:	840
ADDRESS:	18868 BOLLINGER CANYON RD		TELEPHONE:	(925) 820-2515
CITY:	SAN RAMON	STATE: CA	ZIP CODE:	94583
CAPACITY:	20	CENSUS: 8	DATE:	12/15/2021
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jillian Miller		TIME COMPLETED:	01:35 PM

ALLEGATION(S):

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Child exited facility without supervision.

INVESTIGATION FINDINGS:

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On December 15, 2021 at 9:00am, Licensing Program Analyst (LPA) Julia Placencia arrived unannounced to conduct the Initial 10-day complaint investigation regarding the allegation above. LPA met with interim director Jillian Miller and assistant director Gabriela Herrera. There were 8 children and an additional 2 staff members present.

During the course of the investigation, LPA conducted interviews and reviewed documents. It has been disclosed that on 11/30/21 around 4:10pm, C1 exited his classroom alone without his teacher’s knowledge. C1 walked up the stairs in front of the school and knocked on another classroom door (preschool room #8). C1’s teacher was called and he was returned to his classroom. C1’s teacher mistakenly thought C1 was already picked up by his parent.

***Continued on LIC 9099C..

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

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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Control Number 52-CC-20211213111915

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: CHILD DAY SCHOOL, LLC - SAN RAMON	FACILITY NUMBER: 073406634
	VISIT DATE: 12/15/2021

NARRATIVE

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Based on observations, 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.

The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in each child's file to be reviewed by licensing.

This is a Zero Tolerance violation. An immediate $500 civil penalty is assessed today and $100 per day will be assessed until corrected. LIC 421M was provided. Subsequent Zero Tolerance violations may result in $1000 immediate civil penalty and $100 per day until corrected.

Exit interview conducted with interim director Jillian Miller and copy of report provided. Notice of Site visit provided and must be posted for 30 days.

SUPERVISOR'S NAME: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

LIC9099 (FAS) - (06/04)

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Control Number 52-CC-20211213111915

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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: CHILD DAY SCHOOL, LLC - SAN RAMON	FACILITY NUMBER: 073406634
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/15/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 12/16/2021 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and 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	1 2 3 4 5 6 7	POC: By 12/16/21, a written plan of action must be sent to licensing detailing the steps staff will take to ensure children are supervised at all times. **This is a Zero Tolerance violation. An immediate $500 civil penalty is assessed today and $100 per day will be assessed until corrected.
	8 9 10 11 12 13 14	101230(c)(1). Supervision shall include visual observation. This requirement is not met as evidenced by: Based on interviews conducted, C1 exited his classroom alone without staff’s knowledge, which poses an immediate health and safety risk to children in care.	8 9 10 11 12 13 14	Subsequent Zero Tolerance violations may result in $1000 immediate civil penalty and $100 per day until corrected.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Jason Jang	TELEPHONE: (510) 622-2631
LICENSING EVALUATOR NAME: Julia Placencia	TELEPHONE: (510) 725-5998
LICENSING EVALUATOR SIGNATURE:	DATE: 12/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/15/2021

LIC9099 (FAS) - (06/04)

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