013420567-8-14-2024-02-CC-MMEA-D8CP92-20240821110622

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013420567
Report Date: 08/14/2024
Date Signed: 08/14/2024 05:36:08 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
05/24/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240524102433

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: 30	DATE:	08/14/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Elizabeth Murray		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

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9

Facility does not have adequate telephone service

INVESTIGATION FINDINGS:

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13

On August 14, 2024 at 9:15am Licensing Program Analyst (LPA) Indira Loza met with Interim Director Elizabeth Murray to conduct a complaint investigation for the above allegation. There were 8 toddlers, 30 preschoolers, and 8 fingerprint cleared staff present during the visit.

Based on records reviewed and interviews conducted, it was determined that although the center Director was notified that the phone lines were going to be serviced on March 11, 2024 for a change of telephone/internet network providers and they weren't wroking on March 27, 2024, it was unable to be determined of the phones were or were not working between March 11 and March 27, 2024. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did occur, therefore this allegation is Unsubstantiated.
Exit interview conducted.
Report and Appeal Rights provided to Interim Director Elizabeth Murray.
Notice of Site visit must remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

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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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
05/24/2024 and conducted by Evaluator Indira Loza

COMPLAINT CONTROL NUMBER: 02-CC-20240524102433

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: 30	DATE:	08/14/2024
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Elizabeth Murray		TIME COMPLETED:	05:45 PM

ALLEGATION(S):

1
2
3
4
5
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7
8
9

Facility operated out of ratio

INVESTIGATION FINDINGS:

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9
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12
13

This is an amended version of the report dated August 14, 2024
On August 14, 2024 at 9:15am Licensing Program Analyst (LPA) Indira Loza met with Interim Director Elizabeth Murray to conduct a complaint investigation for the above allegation. There were 8 toddlers, 30 preschoolers, and 8 fingerprint cleared staff present during the visit. During the course of the investigation staff, parent, and children interviews were conducted and records were reviewed.

Based on interviews conducted and records reviewed, it was determined that the facility was out of ratio on at least five seperate occasions in the morning. The preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED. California Code of Regulations, Title 22 101216(a) is being cited on the attached LIC9099-D with a Type B citation.
Exit interview conducted.
Report and Appeal Rights provided to Director Elizabeth Murray. Notice of Site visit must remain posted for 30 days.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

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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Control Number 02-CC-20240524102433

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: 08/14/2024

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/15/2024 Section Cited CCR 101216.3(a)	1 2 3 4 5 6 7	Teacher-Child Ratios: (a) There shall be a ratio of one teacher visually observing and supervising no more than 12 children in attendance. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	The Director shall send LPA a detailed plan to avoid the facility from going over ratio. This plan shall be submitted to the LPA no later than August 15, 2024.
	8 9 10 11 12 13 14	Based on interviews and records reviewed it was determined that the facility was out of ratio in the mornings on at least five occasions which poses a potential risk to the health, safety, and personal rights 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.

SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Mayla Mendoza
LICENSING EVALUATOR SIGNATURE:	DATE: 08/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024

LIC9099 (FAS) - (06/04)

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