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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013417598
Report Date: 04/30/2025
Date Signed: 04/30/2025 12:31:51 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
02/13/2025 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20250213143740
FACILITY NAME:CUSTER, ANTOINETTEFACILITY NUMBER:
013417598
ADMINISTRATOR:CUSTER, ANTOINETTEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 658-2505
CITY:OAKLANDSTATE: CAZIP CODE:
94608
CAPACITY:14CENSUS: 3DATE:
04/30/2025
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Antoinette CusterTIME COMPLETED:
12:05 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee left children in care unsupervised
Children in care were restrained
Child in care left to cry in pack and play
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/30/25, at 12:00PM, Licensing Program Analysts (LPAs) Catherine Fernandes and Indira Loza arrived unannounced to deliver the findings to the above allegations and met with Licensee Antoinette Custer. Present in care was one infant, and two preschoolers. During the investigation LPAs conducted interviews with parents, staff and children, observed the home, and reviewed documentation regarding the allegations.

There is conflicting information regarding the above allegations. Therefore, the allegations are 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.

Exit interview conducted with Director
Appeal Rights, Report, Notice of Site visit provided.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 04/30/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/30/2025
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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