013423040-12-6-2024-02-CC-MMEA-DBVQA8-20241212105929

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 013423040
Report Date: 12/06/2024
Date Signed: 12/06/2024 01:05:41 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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff do not safeguard children's personal belongings

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Based on Interviews conducted it was stated that when a child's belongings are missing, they are usually in the "lost and found" box or misplaced in another child's cubby. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff are not following physician instructions for the administration of medication for child in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. LPA reviewed the prescription order which states that the diaper rash ointment has to be applied at each diaper change. LPA also reviewed the medication log which revealed that the ointment is being applied approximately 5 times per day. Interviews conducted stated that the staff is applying ointment during each diaper change as the prescription order directs. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted. Report, Notice of Site Visit, and Appeal Rights provided to Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff denied food and/or water to child in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 10 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Based on interviews conducted it was stated that the children have coolers inside and outside where they can refill their water bottles when they are thirsty. Interviews also stated that if a child is hungry, staff will call the Director or an administration staff to bring food from the kitchen. However, if it's close to the serving time for breakfast then they will ask the child to wait 5-10 minutes for the food to arrive. 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, therefore the above allegation has been concluded as Unsubstantiated.
Exit interview conducted.
Report and Appeal Rights provided to Director Jessica Boatner

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff do not serve enough or proper snack items to children in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 46 preschoolers and 10 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Based on Interviews conducted it was stated the children have enough food for a second and third portion, also based on records reviewed it was determined that the center is being serve proper food. 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, therefore this allegation has been concluded as Unsubstantiated,

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 4 of 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	JessicamBoatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff threatened to no longer allow parent/guardian into the facility

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Based on Interviews conducted it was stated that a parent is frequently yelling and cursing at the teachers while children are present. LPA also reviewed written statements from teachers which described the yelling and cursing in front of children. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff do not follow sanitary toileting or diapering practices for children in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Interviews conducted stated that the children are changed before the children transition to another activity and they will also change the diapers as needed. Parent interviews conducted stated that their child are always dry when they pick up their child. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 6 of 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	JessicamBoatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff provides care and supervision while under the influence of drugs or alcohol

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. During Interviews conducted it was stated that they have never suspected any staff person of being under the influence of drugs or alcohol. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 7 of 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff unable to explain an injury sustained to child while in care

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Interviews conducted also stated that the staff are supervising the children at all times, and when an injury occurs they always notify the parents and provide an explanation of how the accident occured. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 8 of 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS:	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff retaliate by not providing fair or consistent services for all children

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. In the complaint allegation it is stated that a child was not allowed to bring in sippy cups but that another child is allowed to use a sippy cup. Interviews conducted revealed that all of the children are treated the same and that sippy cups are not allowed in the preschool classrooms. 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 9 of 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Children are napping in the walkway

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Interviews conducted stated that the children's mats are not placed in the in the walkway, 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 10 of 11

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
09/10/2024 and conducted by Evaluator Indira Loza

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20240910160126

FACILITY NAME:	YMCA EASTLAKE CENTER		FACILITY NUMBER:	013423040
ADMINISTRATOR:	JESSICA BOATNER		FACILITY TYPE:	850
ADDRESS:	1612-45TH AVE		TELEPHONE:	(510) 370-2966
CITY:	OAKLAND	STATE: CA	ZIP CODE:	94601
CAPACITY:	60	CENSUS: 44	DATE:	12/06/2024
		UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Jessica Boatner		TIME COMPLETED:	01:15 PM

ALLEGATION(S):

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There is no hardcopy sign-in and sign-out sheet available for use when the ipad is not working

INVESTIGATION FINDINGS:

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On December 6, 2024 at 9:00am Licensing Program Analyst (LPA) Indira Loza met with Director Jessica Boatner to continue the complaint investigation for the above allegation. Present during today's visit were 44 preschoolers and 11 staff. LPA conducted a tour of the facility for a Health and Safety check.

During the course of the investigation LPA Loza conducted observations, reviewed records and conducted staff, parent, and child interviews. Based on Interviews conducted it was stated that there are hardcopy sign-in and sign-out sheets available in each class in case the tablet loses Wi-Fi connectionAlthough 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, therefore the above allegation has been concluded as Unsubstantiated.

Exit interview conducted.
Report, Notice of Site Visit, and Appeal Rights provided to the Director Jessica Boatner.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2024

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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