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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010200115
Report Date: 06/29/2023
Date Signed: 06/29/2023 03:42:29 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
05/12/2023 and conducted by Evaluator Indira Loza
COMPLAINT CONTROL NUMBER: 02-CC-20230512160631
FACILITY NAME:CHILDRENS COMMUNITY CENTERFACILITY NUMBER:
010200115
ADMINISTRATOR:KATHY CHEWFACILITY TYPE:
850
ADDRESS:1140 WALNUT STTELEPHONE:
(510) 528-6975
CITY:BERKELEYSTATE: CAZIP CODE:
94707
CAPACITY:52CENSUS: 26DATE:
06/29/2023
UNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Encian PastelTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Lack of Supervision - Child was unsupervised for an unknown amount of time
INVESTIGATION FINDINGS:
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On June 29, 2023 at 9:22am Licensing Program Analyst (LPA) Indira Loza and Licensing Program Manager (LPM) Mayla Mendoza met with Teacher Encian Pastel to continue the investigation for the above allegation. Present during the inspection were 26 children and 11 fingerprint cleared staff. During the visit LPA and LPM toured the facility and interviewed staff and children.

During the course of the investigation, the facility was inspected for a health and safety check, collected documents regarding the complaint, interviewed staff, parents, and children. Based on interviews, it has been determined that multiple children were alone in the small walkway by the garden, and another incident where a child went to an empty classroom. Based on the interviews and information obtained throughout the investigation, the preponderance of evidence standard has been met. Therefore, the allegation is SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 is being cited on 9099-D page. Facility shall post a copy of the report in a location where all parents can easily view it. All parents of currently enrolled and newly enrolled children during the next twelve months must sign an
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
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 5
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
05/12/2023 and conducted by Evaluator Indira Loza
COMPLAINT CONTROL NUMBER: 02-CC-20230512160631

FACILITY NAME:CHILDRENS COMMUNITY CENTERFACILITY NUMBER:
010200115
ADMINISTRATOR:KATHY CHEWFACILITY TYPE:
850
ADDRESS:1140 WALNUT STTELEPHONE:
(510) 528-6975
CITY:BERKELEYSTATE: CAZIP CODE:
94707
CAPACITY:52CENSUS: 26DATE:
06/29/2023
UNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Encian Pastel TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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9
Physical Plant - Facility is using an unsafe play structure
INVESTIGATION FINDINGS:
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On June 29, 2023 at 9:22am Licensing Program Analyst (LPA) Indira Loza and Licensing Program Manager (LPM) met with Teacher Encian Paisley to continue the investigation for the above allegation. Present during the inspection were 26 children and 11 fingerprint cleared staff. During the visit LPA and LPM toured the facility and interviewed staff and children.

During the course of the investigation, the facility was inspected for a health and safety check, collected documents regarding the complaint, interviewed staff, parents, and children. Although a few interviews indicated that the play structure was unsafe, there were other interviews indicating that the play structures was safe and had mats on the bottom to absorb any falls. 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 this allegation is Unsubstantiated.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
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 5
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
05/12/2023 and conducted by Evaluator Indira Loza
COMPLAINT CONTROL NUMBER: 02-CC-20230512160631

FACILITY NAME:CHILDRENS COMMUNITY CENTERFACILITY NUMBER:
010200115
ADMINISTRATOR:KATHY CHEWFACILITY TYPE:
850
ADDRESS:1140 WALNUT STTELEPHONE:
(510) 528-6975
CITY:BERKELEYSTATE: CAZIP CODE:
94707
CAPACITY:52CENSUS: 26DATE:
06/29/2023
UNANNOUNCEDTIME BEGAN:
09:22 AM
MET WITH:Encian PastelTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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9
Personal Rights - Facility is allowing children to play violent games, threatening the mental health of other children in care
INVESTIGATION FINDINGS:
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On June 29, 2023 at 9:22am Licensing Program Analyst (LPA) Indira Loza and Licensing Program Manager (LPM) met with Teacher Encian Pastel to continue the investigation for the above allegation. Present during the inspection were 26 children and 11 fingerprint cleared staff. During the visit LPA and LPM toured the facility and interviewed staff and children.

During the course of the investigation, the facility was inspected for a health and safety check, collected documents regarding the complaint, interviewed staff, parents, and children. Although a few interviews indicated there were games that were rough towards children, other interviews indicated children were guiding themselves away from games that they didn't feel comfortable playing. 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 this allegation is Unsubstantiated.
An exit interview was conducted with Teacher Encian Pastel. Report and Appeal Rights provided. Notice of Site Visit must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 02-CC-20230512160631
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: CHILDRENS COMMUNITY CENTER
FACILITY NUMBER: 010200115
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/29/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/30/2023
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care & Supervision (a) The licensee shall provide care and supervision as necessary to meet the children's needs (1) No child(ren) shall be left without the supervision of a teacher at any time [...] Supervision shall include visual
observation. This requirement was not met
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Director shall submit a written plan, by 6/30/23 to CCL on how will ensure complete supervision of children in care at all times. The Director shall also hold an all staff meeting, and send the minutes and all signatures of the particiapants to the LPA no later than July 31, 2023.
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as evidenced by: Based on interviews, it was determined that multiple children were left unsupervised which is an immediate risk to the health and safety of the children in care,
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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: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 02-CC-20230512160631
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: CHILDRENS COMMUNITY CENTER
FACILITY NUMBER: 010200115
VISIT DATE: 06/29/2023
NARRATIVE
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LIC9224 acknowledgement form and place in each child's file.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
LIC9099 (FAS) - (06/04)
Page: 5 of 5