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

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073403663
Report Date: 10/13/2021
Date Signed: 10/13/2021 05:05:49 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
08/26/2021 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20210826141050
FACILITY NAME:ST. PATRICK PRESCHOOLFACILITY NUMBER:
073403663
ADMINISTRATOR:CAMPBELL, STEPHANIEFACILITY TYPE:
850
ADDRESS:907 SEVENTH STREETTELEPHONE:
(510) 799-2506
CITY:RODEOSTATE: CAZIP CODE:
94572
CAPACITY:45CENSUS: 27DATE:
10/13/2021
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Carmen LacombaTIME COMPLETED:
05:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Children's diapers are not changed as frequently as needed
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Cherie Acosta conducted an unannounced visit to investigate the above allegation.

During the investigation LPA conducted interviews. Based on interviews conducted it is determined that children have been left in soiled/wet diapers on more than one occasion.

Based on interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

Notice of Site Visit was provided and must be posted for 30 days.
Exit interview was conducted with Carmen Lacomba.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
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-20210826141050
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: ST. PATRICK PRESCHOOL
FACILITY NUMBER: 073403663
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/13/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2021
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
The director shall submit a written plan of action explaining how the facility will ensure children's diapers are changed frequently as needed. The director shall submit the plan to CCL by 10/25/21
8
9
10
11
12
13
14
This requirement was not met as evidenced by: it is determined that children have been left in soiled/wet diapers on more than one occasion which poses a potential 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: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 10/13/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/13/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 4