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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700412
Report Date: 05/24/2023
Date Signed: 05/24/2023 10:10:24 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/15/2023 and conducted by Evaluator Sidney Cortez
COMPLAINT CONTROL NUMBER: 52-CC-20230315101121
FACILITY NAME:MINER, KAILANFACILITY NUMBER:
015700412
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:8CENSUS: 7DATE:
05/24/2023
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Kailan MinerTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights

***Please note this allegation was investigated by IB, Investigator Victoria McIntosh and issued her own findings
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 24, 2023, 9:20am Licensing Program Analyst (LPA) Sidney Cortez met with Licensee Kailan Miner to delivered the findings of the Complaint Investigation. Present on this visit were 7 children, licensee's fingerprint cleared fiance Paul Perilla, and her fingerprint cleared assistant Eugene Adsuara. Facility operates from Monday to Friday 7:00am to 6:00pm.

The allegation that a daycare child sustained unexplained injury while in care was UNSUBSTANTIATED. Based on the investigation conducted by Investigator Victoria McIntosh of Investigation Bureau (IB) interviews, observations, record review(s), and forensic investigation there was no preponderance of evidence to prove the alleged violation occurred.

LPA Cortez obtained copies of facility Children Roster, Staff Roster. An Exit Interview was conducted with Licensee. Provided Notice of Site Visit
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
03/15/2023 and conducted by Evaluator Sidney Cortez
COMPLAINT CONTROL NUMBER: 52-CC-20230315101121

FACILITY NAME:MINER, KAILANFACILITY NUMBER:
015700412
ADMINISTRATOR:MINER, KAILANFACILITY TYPE:
810
ADDRESS:61 CASTRO ST.TELEPHONE:
(510) 309-2914
CITY:SAN LEANDROSTATE: CAZIP CODE:
94577
CAPACITY:8CENSUS: 7DATE:
05/24/2023
UNANNOUNCEDTIME BEGAN:
09:20 AM
MET WITH:Kailan MinerTIME COMPLETED:
11:15 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Other
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On May 24, 2023, 9:20am Licensing Program Analyst (LPA) Sidney Cortez met with Licensee Kailan Miner to delivered the findings of the Complaint Investigation. Present on this visit were 7 children, licensee's fingerprint cleared fiance Paul Perilla, and her fingerprint cleared assistant Eugene Adsuara. Facility operates from Monday to Friday 7:00am to 6:00pm.

The allegation that an Unqualified adult is providing care and supervision to daycare chidlren was UNSUBSTANTIATED. Based on the investigation conducted, interviews, observations, and record review(s), there was no preponderance of evidence to prove the alleged violation occurred.

LPA Cortez obtained copies of facility Children Roster, Staff Roster. An Exit Interview was conducted with Licensee. Provided Notice of Site Visit
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Sidney Cortez
LICENSING EVALUATOR SIGNATURE:

DATE: 05/24/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/24/2023
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 2