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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013423749
Report Date: 08/16/2024
Date Signed: 08/16/2024 01:10:35 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
06/19/2024 and conducted by Evaluator Diana Campos
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240619140755
FACILITY NAME:OMESCUELITA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
013423749
ADMINISTRATOR:AMY CHAPPELLEFACILITY TYPE:
850
ADDRESS:2162 MOUNTAIN BLVD SUITE 200TELEPHONE:
(650) 944-9655
CITY:OAKLANDSTATE: CAZIP CODE:
94611
CAPACITY:84CENSUS: 60DATE:
08/16/2024
UNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Claudia SantanaTIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Facility did not report outbreak of Hand, Foot, Mouth disease to Community Care Licensing Department.
INVESTIGATION FINDINGS:
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LPAs Kareeca Sykes and Diana Campos met with Administrator Claudia Santana for a complaint investigation regarding the above allegation. Present today upon LPA's arrival, there were 14 staff members supervising 47 preschoolers and 13 infants. During the course of the investigation, interviews were conducted and files reviewed. Review of records revealed that facility did not report an outbreak of Hand, Foot and Mouth disease to the licensing office within 24 hours of the confirmed incident.
Based on interviews which were conducted and record review(s), the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter Number (101416.5)), are being cited on the attached LIC 9099D.

An exit interview was conducted with Assistant Director Claudia Santana.

A Notice of Site Visit was provided and must be posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
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-20240619140755
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: OMESCUELITA CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 013423749
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/16/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/23/2024
Section Cited
CCR
101212(a)(d)(1)(E)
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101212 Reporting Requirements
(a) Each licensee or applicant shall furnish to the Department reports as required by the Department including, but not limited to, the following:(d) Upon the occurrence, during the operation of the child care center of any of the events specified in (d)(1) below, a report shall be made to the Department by telephone or fax within the Department's next working day and during its normal business hours. In addition, a written report containing the information specified in (d)
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Facility reported the incidents following the initial 10 day visit as well as subsequent incidents. Facility shall submit to LPA by the POC date a summary of their understanding of the reporting requirement regulation.
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(2) below shall be submitted to the Department within seven days following the occurrence of such... (1) Events reported shall include the following: (E) Epidemic outbreaks. This requirement was not met as evidenced by: Facility did not report outbreak of HFM disease within the required time frame.
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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: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 08/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2024
LIC9099 (FAS) - (06/04)
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