073407727-4-5-2021-02-CC-SJON-C28SNJ-20210419140135

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073407727
Report Date: 04/05/2021
Date Signed: 04/05/2021 06:13:53 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
01/15/2021 and conducted by Evaluator Cherie Acosta

COMPLAINT CONTROL NUMBER: 02-CC-20210115135416

FACILITY NAME:	QUINTANA, REBECA		FACILITY NUMBER:	073407727
ADMINISTRATOR:	QUINTANA, REBECA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(510) 962-1787
CITY:	EL CERRITO	STATE: CA	ZIP CODE:	94530
CAPACITY:	14	CENSUS: 6	DATE:	04/05/2021
		UNANNOUNCED	TIME BEGAN:	04:00 PM
MET WITH:	Rebecca Quintana		TIME COMPLETED:	05:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Staff used inappropriate form of discipline with child in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

Licensing Program Analyst (LPA) Cherie Acosta spoke to licensee by telephone to close the complaint for the above allegation.

During the course of investigation LPA interviewed the licensee, staff, parents and children in care. It was reported that the licensee inappropriately disciplined a child in care. Based on interviews conducted LPA is unable to determine if the alleged incident occurred.

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 occur, therefore the allegation is deemed unsubstantiated.

Report was reviewed with Rebecca Quintana.
Licensee agrees to sign and return this report by 4/6/21.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Cherie Acosta	TELEPHONE: (510) 622-1623
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2021

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 2