073405685-1-27-2023-02-CC-CCON-CNGVZJ-20230127155250

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073405685
Report Date: 11/29/2022
Date Signed: 01/27/2023 03:52:50 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 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
09/12/2022 and conducted by Evaluator Caroline Colson

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20220912122945

FACILITY NAME:	HAPPY LION DAY CARE CENTER		FACILITY NUMBER:	073405685
ADMINISTRATOR:	CHAVIS, WEDNESDAY		FACILITY TYPE:	850
ADDRESS:	2929 CASTRO ROAD		TELEPHONE:	(510) 734-9119
CITY:	SAN PABLO	STATE: CA	ZIP CODE:	94806
CAPACITY:	29	CENSUS: 5	DATE:	11/29/2022
		UNANNOUNCED	TIME BEGAN:	02:37 PM
MET WITH:	Wednesday Chavis		TIME COMPLETED:	02:46 PM

ALLEGATION(S):

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Neglect/Lack of Supervision - Child sustained an unexplained injury due to lack of supervision.

INVESTIGATION FINDINGS:

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On Friday, January 27, 2023 1:12 PM, Licensing Program Analyst (LPA) Caroline Colson met with Betty Hill, Teacher, and Wednesday Chavis, Center Director, for an unannounced complaint investigation. There are five (5) children present with two staff members. Interviews were conducted. Evidence was received. Interviews revealed a child went to a district school in the morning. After class ended, a scheduled school bus picked the child up and transported her to this facility. The child sustained an unexplained injury but the location of the injury is unknown. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged allegation did or did not occur. Based upon the investigation, the complaint allegation is Unsubstantiated. Exit interview was conducted. Appeal rights were discussed and given. Notice of Site visit must be posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:	DATE: 01/27/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2023

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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