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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421349
Report Date: 10/06/2021
Date Signed: 10/06/2021 05:16:01 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
08/30/2021 and conducted by Evaluator Phyllis Dyer
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210830093622
FACILITY NAME:KIDS KONNECT PRESCHOOLFACILITY NUMBER:
013421349
ADMINISTRATOR:STINSON, IVYFACILITY TYPE:
850
ADDRESS:8800 FONTAINE STTELEPHONE:
(510) 569-5437
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY:24CENSUS: 9DATE:
10/06/2021
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Ivy StinsonTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights - Staff Person under influence of illegal substance.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LPA Lisa Dyer and LPM Loretta Dyson met with Director Ivy Stinson to deliver complaint investigation findings. The complaint investigation was conducted by Special Investigator Sonia Boyal of the Investigations Branch. During the investigation, interviews were conducted.
Based on the interviews which were conducted and record reviews, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12), are being cited on the attached LIC 9099D.
The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing. Assembly Bill 633 Fact Sheet was given and discussed with the licensee. Exit interview was conducted and the report was discussed. Licensee was provided a copy of their appeal rights. Notice of Site Visit must be posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Phyllis Dyer
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
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 4
Control Number 02-CC-20210830093622
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: KIDS KONNECT PRESCHOOL
FACILITY NUMBER: 013421349
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/07/2021
Section Cited
CCR
101223(a)(2)
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 safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
1
2
3
4
5
6
7
Director states that effectivie immediately employee with be suspended, drug tested and an investigation will be completed.
8
9
10
11
12
13
14
This requirement was not met as evidenced by observation and interviews: Staff was under the influence of illegal substance while caring for children.This poses an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Phyllis Dyer
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 4
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
08/30/2021 and conducted by Evaluator Phyllis Dyer
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210830093622

FACILITY NAME:KIDS KONNECT PRESCHOOLFACILITY NUMBER:
013421349
ADMINISTRATOR:STINSON, IVYFACILITY TYPE:
850
ADDRESS:8800 FONTAINE STTELEPHONE:
(510) 569-5437
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY:24CENSUS: 9DATE:
10/06/2021
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Ivy StinsonTIME COMPLETED:
05:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff person has illegal drug paraphernalia accessible to children in care.

INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
LPA Lisa Dyer and LPM Loretta Dyson met with Director Ivy Stinson to deliver complaint investigation findings. The complaint investigation was conducted by Special Investigator Sonia Boyal of the Investigations Branch. During the investigation, interviews were conducted.
Based on the interviews which were conducted and record reviews, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12), are being cited on the attached LIC 9099D.
The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC 9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing. Assembly Bill 633 Fact Sheet was given and discussed with the licensee. Exit interview was conducted and the report was discussed. Licensee was provided a copy of their appeal rights. Notice of Site Visit must be posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Phyllis Dyer
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 02-CC-20210830093622
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: KIDS KONNECT PRESCHOOL
FACILITY NUMBER: 013421349
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/06/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
10/07/2021
Section Cited
CCR
101223(a)(2)
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 safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
1
2
3
4
5
6
7
Director states there will be trainings on what is appropriate to be brought to work, and facility is purchasing lockers for all employees' personal belongings.
8
9
10
11
12
13
14
This requirement was not met as evidenced by observation and interviews: Staff had illegal drug paraphernalia accessible to children in care. This poses an immediate risk to the health and safety of children in care.
8
9
10
11
12
13
14
Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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: Phyllis Dyer
LICENSING EVALUATOR NAME: Phyllis Dyer
LICENSING EVALUATOR SIGNATURE:

DATE: 10/06/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4