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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010213410
Report Date: 07/28/2023
Date Signed: 07/28/2023 01:09:16 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/08/2023 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20230508100105
FACILITY NAME:HACIENDA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
010213410
ADMINISTRATOR:IMELDA ACOSTAFACILITY TYPE:
850
ADDRESS:4671 CHABOT DRIVETELEPHONE:
(925) 463-2885
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY:136CENSUS: 30DATE:
07/28/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Imelda AcostaTIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights- Staff handled day care child in a rough manner causing injuries.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 28, 2023 at 09:00am, Licensing Program Analysts (LPA) L. Dacanay Breaux and License Program Manager (LPM) C. Charles conducted an unannounced sequent complaint investigation and to deliver findings for a complaint that was received against the facility. LPA met with director Imelda Acosta and explained the nature of the visit. LPA, LPM & Director tour rooms 3, 4, and 5 for an health and safety inspection. Present today was 5 Teachers, 30 preschool children and 1 ABA Therapist. During this sequent visit LPA and LPM conducted interviews with three children.

Based all the interviews conducted and observations during the various site inspections it was determined Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation of Personal Rights (a child being handled in a rough manner) did or did not occur, therefore the allegation is Unsubstantiated.”

This report shall remain on file for 3 years. A Notice of Site Visit was provided and must remain posted for 30 days and appeal rights provided. Exit interview conducted with Director Imedia Acosta.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
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 2
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/08/2023 and conducted by Evaluator Lorraine Dacanay-Breaux
COMPLAINT CONTROL NUMBER: 52-CC-20230508100105

FACILITY NAME:HACIENDA CHILD DEVELOPMENT CENTERFACILITY NUMBER:
010213410
ADMINISTRATOR:IMELDA ACOSTAFACILITY TYPE:
850
ADDRESS:4671 CHABOT DRIVETELEPHONE:
(925) 463-2885
CITY:PLEASANTONSTATE: CAZIP CODE:
94588
CAPACITY:136CENSUS: 30DATE:
07/28/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Imelda AcostaTIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights - Staff locked day care child in a bathroom while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 28, 2023 at 09:00am, Licensing Program Analysts (LPA) L. Dacanay Breaux and License Program Manager (LPM) C. Charles conducted an unannounced sequent complaint investigation and to deliver findings for a complaint that was received against the facility. LPA met with director Imelda Acosta and explained the nature of the visit. LPA, LPM & Director tour rooms 3, 4, and 5 for an health and safety inspection. Present today was 5 Teachers, 30 preschool children and 1 ABA Therapist. During this sequent visit LPA and LPM conducted interviews with three children.
Based all the interviews conducted and observations during the various site inspections.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation of Personal Rights (a child being locked in the bathroom) did or did not occur, therefore the allegation is Unsubstantiated.”

This report shall remain on file for 3 years. A Notice of Site Visit was provided and must remain posted for 30 days and appeal rights provided. Exit interview conducted with Director Imedia Acosta.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: Lorraine Dacanay-Breaux
LICENSING EVALUATOR SIGNATURE:

DATE: 07/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/28/2023
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 2