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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013415659
Report Date: 11/03/2025
Date Signed: 11/03/2025 10:37:15 AM

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
09/29/2025 and conducted by Evaluator Mario Caro
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20250929090335
FACILITY NAME:NIKASIA CHILD CARE CENTERFACILITY NUMBER:
013415659
ADMINISTRATOR:LEWIS, GWENDOLYNFACILITY TYPE:
830
ADDRESS:4143 MAC ARTHUR BOULEVARDTELEPHONE:
(510) 531-9130
CITY:OAKLANDSTATE: CAZIP CODE:
94619
CAPACITY:8CENSUS: 2DATE:
11/03/2025
UNANNOUNCEDTIME BEGAN:
08:09 AM
MET WITH:Lewis, GwendolynTIME COMPLETED:
10:51 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Facility didn't report hand foot and mouth outbreak.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 11/03/25 at 8:09 am Licensing Program Analyst (LPA) Mario Caro conducted an Unannounced Continued Complaint Investigation and met with Director Gwendolyn Lewis. During the visit there were 2 infants in care and 1 additional staff. During today's visit LPA observed classroom activity, conducted interviews, and Delivered findings.

An allegation was made that the Facility didn't report a hand foot and mouth outbreak. Interviews indicated there was only one confirmed case in the infant center therefore the allegation is UNSUBSTANTIATED which means 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. No Deficiency has been cited for this allegation. Finding was delivered. Exit interview conducted and report was provided to Director Gwendolyn Lewis.

A NOTICE OF SITE VISIT WAS ISSUED AND MUST BE POSTED FOR 30 CONSECUTIVE DAYS
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Mario Caro
LICENSING EVALUATOR SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
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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