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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013418921
Report Date: 05/20/2021
Date Signed: 05/20/2021 02:47:00 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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
05/11/2021 and conducted by Evaluator Loretta Dyson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210511151026
FACILITY NAME:KANBERGS, CHRISTINEFACILITY NUMBER:
013418921
ADMINISTRATOR:KANBERGS, CHRISTINEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 521-7132
CITY:ALAMEDASTATE: CAZIP CODE:
94501
CAPACITY:14CENSUS: 6DATE:
05/20/2021
UNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Christine KanbergsTIME COMPLETED:
03:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child left unattended
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 5/20/21 at 12:25pm, Licensing Program Manager (LPM) Loretta Dyson and Licensing Program Analyst (LPA) Lakeisha Chew arrived at the home for an unannounced complaint investigation regarding the above allegation. LPM and LPA met with the licensee, Christine Kanbergs. There were 6 children and 2 additional fingerprint cleared assistants also present.

The above allegation is something that was addressed during a case management inspection on 5/11/21. At that time, LPM and LPA conducted interviews and reviewed documents to make a determination of whether or not a violation occurred. There was enough information to support that a violation of the regulation occurred and a deficiency was cited on 5/11/21. This complaint is being substantiated based on information previously obtained from the interviews conducted and review of documents for the case management inspection, however another deficiency will not be cited. There are no deficiencies being cited today. This report will remain on file for 3 years. A Notice of Site Visit was provided to the licensee and the licensee was reminded to have it posted for 30 days. An exit interview was conducted.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Diane Perez
LICENSING EVALUATOR NAME: Loretta Dyson
LICENSING EVALUATOR SIGNATURE:

DATE: 05/20/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021
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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