<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013411745
Report Date: 04/08/2022
Date Signed: 04/08/2022 12:24:15 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 STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/06/2022 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20220406130828
FACILITY NAME:CHABOT COLLEGE, CHILDREN'S CENTERFACILITY NUMBER:
013411745
ADMINISTRATOR:MUNOZ, JEMIMAFACILITY TYPE:
850
ADDRESS:25555 HESPERIAN BOULEVARDTELEPHONE:
(510) 723-6684
CITY:HAYWARDSTATE: CAZIP CODE:
94545
CAPACITY:120CENSUS: 18DATE:
04/08/2022
UNANNOUNCEDTIME BEGAN:
10:19 AM
MET WITH:Melissa VoTIME COMPLETED:
12:23 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights - Daycare child sustained bruise while in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 4/8/2022 at 10:19am Licensing Program Analyst (LPA) Morgan Pringle conducted an complaint investigation for an allegation that was made stating a child sustained a bruise while in care. LPA Pringle conducted four (4) interviews during visit. All interviews conducted confirmed that the incident did in fact happen. LPA Pringle did observe that the bruise on the child does coinside with where the child was held during the incident.

Based on interviews and record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be Substantiated. California Code of Regulations, Title 22 is being cited on the attached LIC 9099D. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in civil penalties.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2022
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
Control Number 52-CC-20220406130828
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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: CHABOT COLLEGE, CHILDREN'S CENTER
FACILITY NUMBER: 013411745
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/08/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/22/2022
Section Cited
CCR
101223(a)(3)
1
2
3
4
5
6
7
101223(a)(3) To be free from corporal or unusual punishment, infliction of pain...aids to physical functioning. This requirement was not met as evidenced by: Child sustained a bruise from a teacher while in care of the facility.
1
2
3
4
5
6
7
Director will enroll all staff in a professional development training dealing with the handling of children with difficult behaviors. Director will submit proof of training to be taken by 4/22/2022 and proof of completeion when training has been completed.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 04/08/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/08/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2