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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013423739
Report Date: 12/19/2023
Date Signed: 12/19/2023 01:44:16 PM

Unsubstantiated


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
11/22/2023 and conducted by Evaluator Monica Mathur
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20231122113219
FACILITY NAME:YMCA OF THE EAST BAY - BURBANK EARLY LEARNING CENFACILITY NUMBER:
013423739
ADMINISTRATOR:MELANIE MUELLERFACILITY TYPE:
850
ADDRESS:3550 - 64TH AVENUETELEPHONE:
(510) 809-2261
CITY:OAKLANDSTATE: CAZIP CODE:
94605
CAPACITY:60CENSUS: 11DATE:
12/19/2023
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Khrystal GomesTIME COMPLETED:
01:00 PM
ALLEGATION(S):
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Personal rights - Staff failed to always keep toddler clean and dry.
INVESTIGATION FINDINGS:
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On 12/19/23 Licensing Program Analysts (LPAs) Monica Mathur and Brindha Govindasamy conducted an unannounced Subsequent Complaint Investigation at YMCA of the East Bay Burbank Learning Center. Area Manager, Monica Williams was out of office for the week and center does not have a Director at present. LPAs met with Head Teacher, Khrystal Gomes and explained the purpose of today's inspection. Complainant alleges that staff failed to keep toddler clean and dry, and child has gone home in wet clothing/diaper on multiple occasions.

During course of investigation LPAs conducted facility inspection, observations, record review, interviews and obtained documents. It was determined that there was one incident when Child C1 spilled water on its shirt. This happened at around 3pm pick up time. 2 staff present in the room noticed a water puddle on the floor and cleaned it up. However, they did not see the spill on child's clothing. At that moment child's parent arrived for pick up and left with the child but did not observe wet clothing right away. Parent informed center later. Staff states C1 has not had multiple wet accidents or dirty diapers except on this one particular occasion. They admit not seeing the wet patch due to shirt color and timing of pick up.
continued...on 809-C
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
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-20231122113219
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: YMCA OF THE EAST BAY - BURBANK EARLY LEARNING CEN
FACILITY NUMBER: 013423739
VISIT DATE: 12/19/2023
NARRATIVE
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continued from 9099

Toileting procedure is to check and change every 2 hours or as needed. Staff states they follow this policy for all toddlers including C1. At this time there is not enough information or evidence to determine if child was left in wet clothing and/or wet/dirty diaper on multiple occasions or not.

Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED which means although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. No Deficiency has been cited for this allegation. Technical Violation/Advisory Note was given for Personal rights. Exit interview conducted with Head Teacher, Khrystal Gomes.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 DAYS.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2