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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013420567
Report Date: 10/25/2024
Date Signed: 10/25/2024 04:29:27 PM

Substantiated


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
07/31/2024 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240731111036
FACILITY NAME:CCLC - CLIF BASE CAMP CHILD CARE CENTERFACILITY NUMBER:
013420567
ADMINISTRATOR:WOO, LANIFACILITY TYPE:
850
ADDRESS:6529 HOLLIS STREETTELEPHONE:
(510) 596-6699
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:48CENSUS: 10DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Elizabeth MurrayTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff are not providing appropriate supervision to children in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/25/24, at 3:00PM, Licensing Program Analyst (LPA) Catherine Fernandes and Mario Caro arrived unannounced to deliver the findings to the above allegation and met with Director Elizabeth Murray. Present in care were ten preschoolers with additional four staff members. During the investigation LPA Fernandes conducted interviews, reviewed center documentation regarding the allegation and did a walk through of the center.
Interviews indicated staff have been on their cell phones and a staff member worked while intoxicated. Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. Title 22, California Code of Regulations are being cited on the attached LIC 9099D.

LPAs Fernandes and Caro informed Director Elizabeth Murray that this report dated 10/25/24 documents three Type A citations which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Report continues on 9099C
Deficiencies cited on 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 9
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
07/31/2024 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240731111036

FACILITY NAME:CCLC - CLIF BASE CAMP CHILD CARE CENTERFACILITY NUMBER:
013420567
ADMINISTRATOR:WOO, LANIFACILITY TYPE:
850
ADDRESS:6529 HOLLIS STREETTELEPHONE:
(510) 596-6699
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:48CENSUS: 10DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Elizabeth MurrayTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility operated out of ratio
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/25/24, at 3:00PM, Licensing Program Analyst (LPA) Catherine Fernandes and Mario Caro arrived unannounced to deliver the findings to the above allegation and met with Director Elizabeth Murray. Present in care were ten preschoolers with additional four staff members. During the investigation LPA Fernandes conducted interviews, reviewed center documentation regarding the allegation and did a walk through of the center.
Interviews indicated there have been times where children in care were left out of ratio. Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. Title 22, California Code of Regulations are being cited on the attached LIC 9099D.

LPAs Fernandes and Caro informed Director Elizabeth Murray that this report dated 10/25/24 documents three Type A citations which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Report continues on 9099C
Deficiencies cited on 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 9
Control Number 02-CC-20240731111036
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: CCLC - CLIF BASE CAMP CHILD CARE CENTER
FACILITY NUMBER: 013420567
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/28/2024
Section Cited
CCR
101216.39(a)
1
2
3
4
5
6
7
Teacher-Child Ratio- There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance.. This requirement has not been met as evidenced by:
1
2
3
4
5
6
7
The center will provided schedules of staff and children for the month of November to ensure proper ratios, then send the schedule to CCL by POC date.
8
9
10
11
12
13
14
Based on interviews children in care have been left without a teacher leaving the classroom out of ratio which is an immediate risk to the safety of children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 9
Control Number 02-CC-20240731111036
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: CCLC - CLIF BASE CAMP CHILD CARE CENTER
FACILITY NUMBER: 013420567
VISIT DATE: 10/25/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Also, LPAs Fernandes and Caro informed the Director to provide a copy of this licensing report dated 10/25/24 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.


Exit interview conducted
Report, Appeal Rights, Notice of site visit and LIC9224.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 9
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
07/31/2024 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240731111036

FACILITY NAME:CCLC - CLIF BASE CAMP CHILD CARE CENTERFACILITY NUMBER:
013420567
ADMINISTRATOR:WOO, LANIFACILITY TYPE:
850
ADDRESS:6529 HOLLIS STREETTELEPHONE:
(510) 596-6699
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:48CENSUS: 10DATE:
10/25/2024
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Elizabeth MurrayTIME COMPLETED:
04:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility staff handles children in care in a rough manner
Facility staff yell/speak to children in an inappropriate manner
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 10/25/24, at 3:00PM, Licensing Program Analyst (LPA) Catherine Fernandes and Mario Caro arrived unannounced to deliver the findings to the above allegation and met with Director Elizabeth Murray. Present in care were ten preschoolers with additional four staff members. During the investigation LPA Fernandes conducted interviews, reviewed center documentation regarding the allegation and did a walk through of the center.
Interviews indicated that staff members have spoken to children in an inappropriately and have handled children in a rough manner. Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. Title 22, California Code of Regulations are being cited on the attached LIC 9099D.
LPAs Fernandes and Caro informed Director Elizabeth Murray that this report dated 10/25/24 documents three Type A citations which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.
Report continues on 9099C
Deficiencies cited on 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 5 of 9
Control Number 02-CC-20240731111036
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: CCLC - CLIF BASE CAMP CHILD CARE CENTER
FACILITY NUMBER: 013420567
VISIT DATE: 10/25/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Also, LPAs Fernandes and Caro informed the Director to provide a copy of this licensing report dated 10/25/24 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.


Exit interview conducted
Report, Appeal Rights, Notice of site visit and LIC9224.
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 9
Control Number 02-CC-20240731111036
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: CCLC - CLIF BASE CAMP CHILD CARE CENTER
FACILITY NUMBER: 013420567
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/28/2024
Section Cited
CCR
101223(a)(1)
1
2
3
4
5
6
7
Personal Rights The licensee shall ensure that each child is accorded the following personal rights: To be accorded dignity in his/her personal relationships with staff and other persons. This requirements has not been met as evidenced by:
1
2
3
4
5
6
7
The center will plan and schedule a staff meeting regarding the children's personal rights and send the agenda, date and what staff will be attending by POC date.
8
9
10
11
12
13
14
Based on interviews the center failed to ensure the children's right were not violated which is an immediate risk to the children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 7 of 9
Control Number 02-CC-20240731111036
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: CCLC - CLIF BASE CAMP CHILD CARE CENTER
FACILITY NUMBER: 013420567
VISIT DATE: 10/25/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Also, LPAs Fernandes and Caro informed the Director to provide a copy of this licensing report dated 10/25/24 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.


Exit interview conducted
Report, Appeal Rights, Notice of site visit and LIC9224 provided
SUPERVISOR'S NAME: Mayla MendozaTELEPHONE: (510) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 8 of 9
Control Number 02-CC-20240731111036
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: CCLC - CLIF BASE CAMP CHILD CARE CENTER
FACILITY NUMBER: 013420567
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
10/28/2024
Section Cited
CCR
101229(a)
1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision ; The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement has not been met as evidenced by:
1
2
3
4
5
6
7
Center will come up with a plan to ensure that appropriate supervision meets the children's needs. Then send the plan to CCL by POC date.
8
9
10
11
12
13
14
Based on interviews the center failed to meet the children's supervision needs which is an immediate safety risk to children in care.
8
9
10
11
12
13
14
CCR
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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) 873-6408
LICENSING EVALUATOR NAME: Catherine FernandesTELEPHONE: (510) 725-7002
LICENSING EVALUATOR SIGNATURE:

DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2024
LIC9099 (FAS) - (06/04)
Page: 9 of 9