073408290-7-29-2021-02-CC-SJON-C6DMLH-20210830094222

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073408290
Report Date: 07/29/2021
Date Signed: 07/29/2021 12:43:35 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
06/30/2021 and conducted by Evaluator Michelle Sutton

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20210630101703

FACILITY NAME:	ST. JOHN'S PRESCHOOL		FACILITY NUMBER:	073408290
ADMINISTRATOR:	SHONECE BARNEY		FACILITY TYPE:	850
ADDRESS:	5555 CLAYTON ROAD		TELEPHONE:	(925) 672-8855
CITY:	CLAYTON	STATE: CA	ZIP CODE:	94517
CAPACITY:	58	CENSUS: 11	DATE:	07/29/2021
		UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Tonya Dean		TIME COMPLETED:	12:45 PM

ALLEGATION(S):

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Personal Rights- Staff did not change daycare child’s soiled clothing

INVESTIGATION FINDINGS:

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On 7/29/21 Licensing Program Analysts (LPAs) Michelle Sutton and Monica Mathur conducted an Unannounced Subsequent Complaint Investigation at St. John's Preschool and met with Director Tonya Dean. During the course of the investigation the Department completed a physical plant inspection, reviewed facility, child/staff records, and conducted interviews. Complaint allegation is that Staff did not change daycare child’s soiled clothing a violation of Personal Rights. Based on the interviews, inspection and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED. 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 UNSUBSTANTIATED. Tonya was reminded that staff should be always aware that child's personal rights cannot be violated. No Deficiencies have been cited for the allegation. Exit interview conducted with Director Tonya Dean, Tonya where this report was discussed and signatures obtained acknowledging receipt of documents. A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Sherelle Johnson	TELEPHONE: (510) 622-2592
LICENSING EVALUATOR NAME: Michelle Sutton	TELEPHONE: (510) 725-7004
LICENSING EVALUATOR SIGNATURE:	DATE: 07/29/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/29/2021

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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