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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408503
Report Date: 06/04/2021
Date Signed: 06/04/2021 02:58:09 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
05/13/2021 and conducted by Evaluator Paul Peterson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210513081702
FACILITY NAME:BOLDEN-KRAMER, RACHELFACILITY NUMBER:
073408503
ADMINISTRATOR:BOLDEN-KRAMER, RACHELFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 779-2786
CITY:EL SOBRANTESTATE: CAZIP CODE:
94803
CAPACITY:14CENSUS: 6DATE:
06/04/2021
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Rachel Bolden-KramerTIME COMPLETED:
12:30 PM
ALLEGATION(S):
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Provider engaged in inappropriate verbal interaction with a parent in the presence of children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Paul Petersen conducted an unannounced complaint investigation site inspection for this facility regarding the above allegation. There were six children in care today consisting of two infants (including licensee's one year old child), four preschoolers and licensee's seven year old child. LPA met with licensee, Rachel Bolden-Kramer. Also present at the time of this inspection were licensee's partner, Makinde Pecanha, assistant,Alaafia Shambe, and assistant, Analeticia Sosa.

LPA discussed the reason for today's visit with licensee. During this investigation it was determined that a parent and licensee were involved in a verbal disagreement which was at times inappropriately loud and included swear words while at least one child in care was present.

The attached Type B deficiency is cited according to Title 22 regulations. Licensee was provided a copy of the appeal rights. An exit interview was conducted, a copy of this complaint investigation report was provided, and a Notice of Site visit was provided and posted.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 368-2672
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021
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 02-CC-20210513081702
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BOLDEN-KRAMER, RACHEL
FACILITY NUMBER: 073408503
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/21/2021
Section Cited
CCR
102423(a)(2)
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102423(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (1) To receive safe, healthful, and
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Licensee agrees to watch the instructional video for child care providers titled "Children's Personal Rights in Child Care" at https://ccld.childcarevideos.org by the POC date specified and to ensure that going forward interactions between adults while children are present will be appropriate for children in care. Failure to
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comfortable accommodations, furnishings, and equipment. This requirement was not met as evidenced by a verbal disagreement between a parent and licensee which involved yellling and swear words while at least one child was in care thereby posing a potential risk to the health and well being of the child.
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correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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: Mayla MendozaTELEPHONE: (510) 292-2724
LICENSING EVALUATOR NAME: Paul PetersonTELEPHONE: (510) 368-2672
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2021
LIC9099 (FAS) - (06/04)
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