013420567-4-10-2024-02-CC-DPEZ-D4P47H-20240425185106

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013420567
Report Date: 02/07/2024
Date Signed: 04/10/2024 01:41:42 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
02/02/2024 and conducted by Evaluator Ashley Akinleye

COMPLAINT CONTROL NUMBER: 02-CC-20240202144353

FACILITY NAME:	CCLC - CLIF BASE CAMP CHILD CARE CENTER		FACILITY NUMBER:	013420567
ADMINISTRATOR:	WOO, LANI		FACILITY TYPE:	850
ADDRESS:	6529 HOLLIS STREET		TELEPHONE:	(510) 596-6699
CITY:	EMERYVILLE	STATE: CA	ZIP CODE:	94608
CAPACITY:	48	CENSUS: 40	DATE:	02/07/2024
		UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Shinyan Beh		TIME COMPLETED:	10:54 AM

ALLEGATION(S):

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Licensee does not ensure the facility is in good repair.

INVESTIGATION FINDINGS:

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THIS IS AN AMENDED REPORT FROM COMPLAINT INSPECTION ON 2/7/2024
On 4/10/24 Licensing Program Analyst (LPA) Ashley Akinleye arrived at Clif Base Camp Child Center to amend report from 2/7/24 the findings were changed, and a new 9099 now supersedes it. LPA was met by assistant site director and explained the purpose of today's visit. LPA previously toured the facility on 2/7/24 with assistant director, Shinyan Beh for a health and safety inspection. During the tour LPA discovered that there had been a leak, a ceiling in need of repair and through interviews discovered that due to the rain there was a potential mold build up. Based on LPA's observations and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is found to be SUBSTANTIATED. California Code of Regulations, [Title 22, Division 12 & Chapter 1, Article 7 (101238a)], are being cited on the attached LIC 9099D.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Ashley Akinleye
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2024

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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