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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010209542
Report Date: 02/05/2025
Date Signed: 03/05/2025 03:03:30 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
01/14/2025 and conducted by Evaluator Indira Loza
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20250114141036
FACILITY NAME:CENTRO VIDA BILINGUAL CHILDCARE CENTERFACILITY NUMBER:
010209542
ADMINISTRATOR:ACOSTA, DIANAFACILITY TYPE:
850
ADDRESS:1000 CAMELIA STREETTELEPHONE:
(510) 525-1463
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY:64CENSUS: 30DATE:
02/05/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Diana AcostaTIME COMPLETED:
04:50 PM
ALLEGATION(S):
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Child sustained a head injury in care
INVESTIGATION FINDINGS:
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This is an amended report from the report dated February 5, 2025.

On February 5, 2025 at 9:10am Licensing Program Analyst (LPA) Indira Loza arrived at the facility to continue the investigation for the above allegation. LPA met with Program Director Yanci Lucero and Center Director DIana Acosta. Present during today's visit were 30 preschoolers and 7 fingerprint cleared staff. LPA toured the facility for a health and safety check.

During the course of the investigation LPA conducted interviews and record reviews which revealed that there was inadequate supervision during the time that the incident occurred. During this time, two teachers went on break, and one teacher left the playground to change a child's diaper. This left one fully qualified teacher and one aide with 19 children which was when a child was standing on a bench, fell backwards, and cut thier head on the metal playhouse. The playground at the time was out of ratio which contributed to the negligence of supervision resulting in the child being able to stand and hitting their
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
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 4
Control Number 02-CC-20250114141036
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: CENTRO VIDA BILINGUAL CHILDCARE CENTER
FACILITY NUMBER: 010209542
VISIT DATE: 02/05/2025
NARRATIVE
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head on the metal playhouse. The preponderance of evidence standard has been met, therefore the allegation is SUBSTANTIATED. Title 22, California Code of Regulations 101229(a) is being cited on the attached LIC 9099 D. The attached type A violation being cited today must be corrected by the due date of February 6, 2025.

Upon receipt, the Director shall post and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC9224 must be placed in the child's file to be reviewed by licensing.

Exit Interview Conducted.
Report and Appeal Rights provided to Director Diana Acosta.
Notice of Site Visit must remain posted for 30 days.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Indira Loza
LICENSING EVALUATOR SIGNATURE:

DATE: 02/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 02-CC-20250114141036
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: CENTRO VIDA BILINGUAL CHILDCARE CENTER
FACILITY NUMBER: 010209542
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/05/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/06/2025
Section Cited
CCR
101229(a)
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Responsibility for Providing Care and Supervision - (a) The licensee shall provide care and supervision as necessary to meet the children's needs.

This requirement was not met as evidenced by:
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The Director shall email a detailed plan that includes methods of increased communication between the staff to ensure that the correct ratio is maintained at all times. The plan shall be emailed to the LPA no later than the close of business on February 6, 2025.
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 Based on records reviewed and interviews conducted, it was determined that the staff failed to provide adequate supervision resulting in a child falling off from a bench and sustaining a head injury. This poses an immediate risk to the health, safety, and personal rights to 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: 02/05/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/05/2025
LIC9099 (FAS) - (06/04)
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