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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013415194
Report Date: 08/12/2021
Date Signed: 08/12/2021 12:03:35 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
08/05/2021 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20210805095245
FACILITY NAME:CELEBRATION LEARNING CENTERFACILITY NUMBER:
013415194
ADMINISTRATOR:JENSEN, JULIEFACILITY TYPE:
840
ADDRESS:1135 BLUEBELL DRIVETELEPHONE:
(925) 245-1252
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:60CENSUS: 27DATE:
08/12/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Julie JensenTIME COMPLETED:
12:15 PM
ALLEGATION(S):
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Staff are not wearing masks
INVESTIGATION FINDINGS:
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On 8/12/2021 Licensing Program Analyst (LPA) Jaylena Miller conducted an unannounced initial 10 day complaint investigation regarding the above allegation and the purpose of the visit was explained to director, Julie Jensen.
During the investigation LPA conducted a physical plant inspection of the facility and took a headcount of all staff and children present.

On 8/12/2021 the facility, Celebration Learning Center, did not ensure the personal rights of persons in care, to safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of persons in care, in that the facility staff did not wear face coverings while in the facility caring for children as required by the California Department of Public health Guidance on the use of Face Coverings issued June 18, 2020 and updated July 28, 2021, and an individual mask exception did not apply.

Please see LIC 9099-C for continuance
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
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 5
Control Number 52-CC-20210805095245
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: CELEBRATION LEARNING CENTER
FACILITY NUMBER: 013415194
VISIT DATE: 08/12/2021
NARRATIVE
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This agency has investigated the complaint alleging the facility staff are not wearing mask. Based on LPAs observation, interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be SUBSTANTIATED. As a result, and per California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101223(a)(2) is being cited. Please see LIC 9099-D for deficiency.

Please see LIC 9099-C for continuation

The director must post this report for thirty days. The licensee must give each parent of the children in care and future parents of newly enrolled children, for the next one year following today’s date, a copy of this report. Parents are to sign an LIC 9224- Acknowledgment of Receipt of Licensing reports and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in additional monetary assessments to the facility. Appeal Rights given to director and Notice of site visit given and must be posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
08/05/2021 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20210805095245

FACILITY NAME:CELEBRATION LEARNING CENTERFACILITY NUMBER:
013415194
ADMINISTRATOR:JENSEN, JULIEFACILITY TYPE:
840
ADDRESS:1135 BLUEBELL DRIVETELEPHONE:
(925) 245-1252
CITY:LIVERMORESTATE: CAZIP CODE:
94550
CAPACITY:60CENSUS: 27DATE:
08/12/2021
UNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Julie JensenTIME COMPLETED:
12:15 PM
ALLEGATION(S):
1
2
3
4
5
6
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8
9
Staff are not requiring children to wear masks
INVESTIGATION FINDINGS:
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3
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5
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7
8
9
10
11
12
13
On 8/12/2021 Licensing Program Analyst (LPA) Jaylena Miller conducted an unannounced initial 10 day complaint investigation regarding the above allegation and the purpose of the visit was explained to director, Julie Jensen.
During the investigation LPA conducted a physical plant inspection of the facility and took a headcount of all staff and children present.

On 8/12/2021 the facility, Celebration Learning Center, did not ensure the personal rights of persons in care, to safe and healthful accommodations and engaged in conduct inimical to the health, welfare, and safety of persons in care, in that the facility staff does not require face coverings for children while indoors at the facility as required by the California Department of Public health Guidance on the use of Face Coverings issued June 18, 2020 and updated July 28, 2021, and an individual mask exception did not apply.

Please see LIC 9099-C for continuance
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 52-CC-20210805095245
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: CELEBRATION LEARNING CENTER
FACILITY NUMBER: 013415194
VISIT DATE: 08/12/2021
NARRATIVE
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This agency has investigated the complaint alleging the facility staff are not wearing mask. Based on LPAs observation, interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be SUBSTANTIATED. As a result, and per California Code of Regulations, Title 22, Division 12, Chapter 1 Section 101223(a)(2) is being cited. Please see LIC 9099-D for deficiency.

On 8/4/2021 the facility received notification two children tested positive for COVID-19 and did not follow proper licensing requirements by calling and reporting the positive cases to community care licensing however, it was reported to the public health department and LPA provided technical assistance regarding reporting unusual incidents to licensing with 24 hours.

The director must post this report for thirty days. The licensee must give each parent of the children in care and future parents of newly enrolled children, for the next one year following today’s date, a copy of this report. Parents are to sign an LIC 9224- Acknowledgment of Receipt of Licensing reports and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in additional monetary assessments to the facility. Appeal rights given to director and Notice of sire visit given and must be posted for 30 days.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 52-CC-20210805095245
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: CELEBRATION LEARNING CENTER
FACILITY NUMBER: 013415194
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/12/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/12/2021
Section Cited
CCR
101223(a)(2)
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101223 Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations... This was not met as evidence by:
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Director will notify all staff and parents that mask are required while indoors immediately. Director will post Guidance for the Use of Masks by the CA Dept. of Public Health for all parents and staff by 8/13/2021.
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Based on observation, interviews and record review, the faciity does not require staff or children to wear mask indoors during the mask mandate which poses an immediate risk to the health and safety to children in care.
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 08/12/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/12/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 5