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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073409577
Report Date: 11/09/2023
Date Signed: 11/09/2023 11:06:03 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
08/28/2023 and conducted by Evaluator Melissa Domantay
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230828132846
FACILITY NAME:APPLETREE CHRISTIAN PRESCHOOL AT VINEYARD ACADEMYFACILITY NUMBER:
073409577
ADMINISTRATOR:APRIL BOWLES-CUDDIHYFACILITY TYPE:
850
ADDRESS:1770 ADAMS LANETELEPHONE:
(925) 518-7274
CITY:BRENTWOODSTATE: ZIP CODE:
94513
CAPACITY:10CENSUS: 7DATE:
11/09/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Tracey HopkinsTIME COMPLETED:
11:45 AM
ALLEGATION(S):
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Unlicensed Care
INVESTIGATION FINDINGS:
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On 11/9/23, Licensing Program Analyst (LPA) M. Domantay conducted an unannounced complaint
investigation to deliver the findings. LPA met with Head Teacher, Tracey Hopkins. LPA conducted staff interviews during today's inspection.

Based on the investigation it is determined that facility was providing unlicensed care to children before the pre-licensing date of 9/7/2023.

See 9099-D for Type A citation.

Based on staff and parent interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. Exit interview conducted and Notice of Site Visit provided and must be posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
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
Control Number 02-CC-20230828132846
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: APPLETREE CHRISTIAN PRESCHOOL AT VINEYARD ACADEMY
FACILITY NUMBER: 073409577
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/09/2023
Section Cited
HSC
1596.80
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No person, firm, partnership, association, or corporation shall operate, establish, manage, conduct, or maintain a child day care facility in this state without a current valid license, therefor as provided in this act.
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Facility is now operating as a licensed facility as of 9/7/2023.
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This was not met as evidenced by staff and parent interviews revealing that unlicensed care was being provided at above facility before the pre-licensing date of 9/7/2023.
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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: Mai Lor
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2