073408291-6-21-2021-02-CC-SJON-C4VU4S-20210713151533

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 073408291
Report Date: 06/21/2021
Date Signed: 06/21/2021 11:22:20 AM

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
05/11/2021 and conducted by Evaluator Monica Mathur

PUBLIC

COMPLAINT CONTROL NUMBER: 02-CC-20210511122422

FACILITY NAME:	KID TIME, INC		FACILITY NUMBER:	073408291
ADMINISTRATOR:	FARRELL, STRETTA		FACILITY TYPE:	850
ADDRESS:	2491 SAN MIGUEL DR.		TELEPHONE:	(925) 930-6550
CITY:	WALNUT CREEK	STATE: CA	ZIP CODE:	94596
CAPACITY:	45	CENSUS: 48	DATE:	06/21/2021
		UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Streeta Farrell		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Building & Grounds – broken, unsafe outdoor equipment resulted in children being hurt

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On 06/21/21 at 9:15 AM Licensing Program Analysts (LPAs) Monica Mathur and Michelle Sutton conducted an unannounced Subsequent Complaint Investigation at Kid Time Inc. LPAs met with Director, Streeta explained the purpose of today’s investigation. LPAs conducted staff interview and observed children engaged in outdoor activities.The finding for the above allegation was also delivered during the investigation.

During the course of the investigation the department completed a physical plant inspection, reviewed facility records, child and staff records, and conducted interviews. Complainant alleges swings are broken, unsafe and children fell after using them. Based on the interviews and information obtained throughout the investigation, the allegation is UNSUBSTANTIATED. 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, therefore the allegation is UNSUBSTANTIATED. No Deficiencies have been cited for this allegation. Exit interview conducted with Director.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED ON OR ADJACENT TO THE INTERIOR SIDE OF THE MAIN DOOR INTO THE FACILITY FOR 30 CONSECUTIVE DAYS.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Monica Mathur
LICENSING EVALUATOR SIGNATURE:	DATE: 06/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

Page: 2 of 2