073407850-5-20-2021-02-CC-SJON-C3UPWX-20210610114125

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073407850
Report Date: 05/20/2021
Date Signed: 05/20/2021 03:36:43 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
03/17/2021 and conducted by Evaluator Cherie Acosta

COMPLAINT CONTROL NUMBER: 02-CC-20210317121048

FACILITY NAME:	BADER, LILIANE		FACILITY NUMBER:	073407850
ADMINISTRATOR:	BADER, LILIANE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 455-5062
CITY:	BRENTWOOD	STATE: CA	ZIP CODE:	94513
CAPACITY:	14	CENSUS: 9	DATE:	05/20/2021
		UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Liliane Bader		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Physical Abuse- Adult in the home hit day care child

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced inspection to investigate the above allegation. Present during the inspection was the licensee, her fingerprint cleared assistant, 4 infants and 5 preschool aged children in care.

It was reported that an adult in the home hit and pulled a day care child's ear while the child was in care. During the investigation interviews were conducted. Based on interviews conducted LPA is not able to determine if the above allegation did or did not occur.

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 reviewed with Licensee. Appeal rights were provided.
Notice of Site Visit was provided and must be posted for 30 days.

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: 05/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021

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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