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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010200370
Report Date: 11/17/2022
Date Signed: 11/17/2022 01:40:04 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
10/26/2022 and conducted by Evaluator Melissa Domantay
COMPLAINT CONTROL NUMBER: 02-CC-20221026092836
FACILITY NAME:LAKESHORE CHILDREN'S CENTERFACILITY NUMBER:
010200370
ADMINISTRATOR:THOMPSON, RAE RITA FFACILITY TYPE:
850
ADDRESS:3518-3546 LAKESHORE AVENUETELEPHONE:
(510) 893-4048
CITY:OAKLANDSTATE: CAZIP CODE:
94610
CAPACITY:49CENSUS: DATE:
11/17/2022
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Teresita ArciagaTIME COMPLETED:
01:45 PM
ALLEGATION(S):
1
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9
Personal Rights - Staff inappropriately discipline child in care.
INVESTIGATION FINDINGS:
1
2
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9
10
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13
Licensing Program Analysts (LPAs) Melissa Domantay and Melissa Guirit met with Teresita Arciaga to deliver the findings of the above allegation. Present at the facility during today's visit were Director Teresita, 2 staff and 12 preschool children. It was alleged that Staff inappropriately discipline child in care.

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 due to staff interviews indicating Director has a loud tone when they speak.

Therefore, the results are Unsubstantiated. Exit interview conducted. Appeal rights were discussed and given. This report must be kept available for public review for 3 years. Notice of Site visit must be posted for 30 days. Copy of report provided to Director.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Melissa Domantay
LICENSING EVALUATOR SIGNATURE:

DATE: 11/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/17/2022
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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