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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010211112
Report Date: 11/15/2024
Date Signed: 11/15/2024 03:54:07 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
09/26/2024 and conducted by Evaluator Diana Campos
COMPLAINT CONTROL NUMBER: 02-CC-20240926205519
FACILITY NAME:MODEL SCHOOL COMPREHENSIVE HUMANISTIC LEARNING CTRFACILITY NUMBER:
010211112
ADMINISTRATOR:SALIH, NAGWAFACILITY TYPE:
850
ADDRESS:2330 PRINCE STREETTELEPHONE:
(510) 549-2711
CITY:BERKELEYSTATE: CAZIP CODE:
94705
CAPACITY:50CENSUS: 34DATE:
11/15/2024
UNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Yvonne SteenTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are operating over ratio
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) J. Vargas and D. Campos conducted an unannounced visit to close the complaint for the above allegation. Present during the investigation were 6 staff and 34 children in care.
It is alleged that staff are operating over ratio. During the course of the investigation, interviews and observations were conducted, files and records were reviewed. Although LPAs observed facility to be in ratio, another party reported the facility is operating over ratio.
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 deemed unsubstantiated at this time.

Exit interview conducted and report reviewed with center Director Yvonne Steen.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
09/26/2024 and conducted by Evaluator Diana Campos
COMPLAINT CONTROL NUMBER: 02-CC-20240926205519

FACILITY NAME:MODEL SCHOOL COMPREHENSIVE HUMANISTIC LEARNING CTRFACILITY NUMBER:
010211112
ADMINISTRATOR:SALIH, NAGWAFACILITY TYPE:
850
ADDRESS:2330 PRINCE STREETTELEPHONE:
(510) 549-2711
CITY:BERKELEYSTATE: CAZIP CODE:
94705
CAPACITY:50CENSUS: 34DATE:
11/15/2024
UNANNOUNCEDTIME BEGAN:
02:55 PM
MET WITH:Yvonne SteenTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are not providing adequate care or supervision
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analysts (LPAs) J. Vargas and D. Campos conducted an unannounced visit to close the complaint for the above allegation. Present during the investigation were 6 staff and 34 children in care.
It is alleged that staff are not providing adequate care or supervision. During the course of the investigation, interviews and observations were conducted, files were reviewed. An incident occurred when a parent arrived for pick up during nap time and observed a staff sleeping in the classroom. Interviews disclosed the staff who was found sleeping was on break and children were being supervised by one staff positioned by the doorway overseeing napping children in both classrooms. Care and supervision was discussed.
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 deemed unsubstantiated at this time.

Exit interview conducted and report reviewed with center Director Yvonne Steen.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Diana Campos
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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