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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 010216108
Report Date: 12/11/2024
Date Signed: 12/11/2024 11:57:57 AM

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
10/03/2024 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20241003145041
FACILITY NAME:OAKLAND HEAD START - TASSAFARONGAFACILITY NUMBER:
010216108
ADMINISTRATOR:LISA ROSSFACILITY TYPE:
850
ADDRESS:975- 85TH AVENUETELEPHONE:
(510) 639-0580
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY:25CENSUS: 3DATE:
12/11/2024
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:RUFF, SANDRA TIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On December 11, 2024 at 10:00 AM Licensing Program Analyst (LPA) Nyeesha Blount, conducted an Unannounced Complaint site inspection to deliver complaint findings. LPA met with Director Ruff, Sandra also present was (1) staff member who is background cleared. LPA advised Director of the nature of the inspection. Current Census today is 3 children which consists of (3) preschool age children present. LPA obtained a copy of the children's roster, observations and staff interviews were conducted.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur. Therefore, the allegation is 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 given.
Unsubstantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2024
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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