<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700588
Report Date: 09/09/2024
Date Signed: 09/09/2024 02:54:53 PM

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
08/28/2024 and conducted by Evaluator Elimika Woods
COMPLAINT CONTROL NUMBER: 52-CC-20240828083536
FACILITY NAME:YMCA OF THE EAST BAY-CHERRYLAND ELCFACILITY NUMBER:
015700588
ADMINISTRATOR:FREEMAN, MICHELEFACILITY TYPE:
850
ADDRESS:21144 MISSION BOULEVARDTELEPHONE:
(510) 247-8287
CITY:HAYWARDSTATE: CAZIP CODE:
94541
CAPACITY:48CENSUS: 30DATE:
09/09/2024
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Michele FreemanTIME COMPLETED:
03:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Physical Plant-Licensee does not ensure facility is free of insects.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On September 9, 2024 at 12:30 PM, Licensing Program Analyst (LPA) Elimika Woods arrived to the facility unannounced to conclude an investigation into the above allegation. Upon arrival LPA was allowed in by the facility representative, Michele Freeman. Present during the visit were 30 preschool age children and five additional staff members. LPA informed the facility representative of the reason for visit and toured the facility.

Licensing Program Analyst (LPA) Elimika Woods investigated the allegation of physical plant being violated. During the course of the investigation, observations, and interviews were conducted. It was alleged that the licensee does not ensure the facility is free of insects. Based on interviews conducted and the report from the pest control company, the compliant is Unsubstantiated, meaning it cannot be proven or disproven that the child care center does not ensure the facility is free of insects, therefore, the allegation is UNSUBSTANTIATED.

Exit interview conducted with Michele Freeman and Notice of Site Visit provided and must be posted for 30 days.
Unsubstantiated
Estimated Days of Completion: 30
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Elimika Woods
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2024
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 1