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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073406683
Report Date: 12/16/2022
Date Signed: 12/16/2022 01:21:54 PM

Unsubstantiated


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
09/26/2022 and conducted by Evaluator Tasha Hackett-Alexander
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20220926123456

FACILITY NAME:WOOD ROSE ACADEMY AND PRESCHOOLFACILITY NUMBER:
073406683
ADMINISTRATOR:HARISDELSY CARDENASFACILITY TYPE:
850
ADDRESS:4347 COWELL ROADTELEPHONE:
(925) 825-4644
CITY:CONCORDSTATE: CAZIP CODE:
94518
CAPACITY:72CENSUS: 28DATE:
12/16/2022
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:HARISDELSY CARDENASTIME COMPLETED:
01:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LICENSING PROGRAM ANALYST TASHA ALEXANDER MET WITH CENTER DIRECTOR HARISDELSY CARDENAS TO DELIVER THE FINDINGS TO THE ABOVE COMPLAINT ALLEGATION.

ON THIS ANALYST'S LAST VISIT, AN INTERVIEWS WERE CONDUCTED WITH STAFF AND DOCUMENTS WERE RECEIVED. FURTHER INVESTIGATION HAS BEEN CONDUCTED.


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 OCCOR, THEREFORE THE ALLEGATION IS UNSUBSTANTIATED.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Loretta DysonTELEPHONE: (510) 695-0243
LICENSING EVALUATOR NAME: Tasha Hackett-AlexanderTELEPHONE: (510) 292-9724
LICENSING EVALUATOR SIGNATURE:

DATE: 12/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/16/2022
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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