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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013420549
Report Date: 11/16/2023
Date Signed: 11/20/2023 09:51:15 AM

Document Has Been Signed on 11/20/2023 09:51 AM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:ALBANY CHILDREN'S CENTERFACILITY NUMBER:
013420549
ADMINISTRATOR:MANSKER, ANNAFACILITY TYPE:
850
ADDRESS:720 JACKSON STREETTELEPHONE:
(510) 559-6590
CITY:ALBANYSTATE: CAZIP CODE:
94706
CAPACITY: 85TOTAL ENROLLED CHILDREN: 85CENSUS: DATE:
11/16/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Joshua ReedTIME COMPLETED:
02:00 PM
NARRATIVE
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This is an Amended Report.

On 11/16/2023 at 9:15AM Licensing Program Analyst (LPA), A. Curry conducted an unannounced visit to follow up on a self-reported incident where a staff handled a child inappropriately. LPA was greeted by the Secretary, Danielle Eichner and the Director, Joshua Reed, who arrived to the facility shortly after. During the visit the LPA reviewed staff files, retrieved documentation, and conducted interviews with staff and children. Based on the information gathered through interviews a staff handled multiple children in an inappropriate manner.

Type A deficiency is being cited. Violation of the California Code of Regulations, Title 22, Division 12, Section 101223(a)(3) is being cited on the attached LIC 809D.

LPA A. Curry informed Director, Joshua Reed, that this report dated 11/16/2023 document(s) 1 Type A citation(s) which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA A. Curry informed the Director, Joshua Reed, to provide a copy of this licensing report dated 11/16/2023 that documents any Type A citation(s) to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.


Exit interview conducted, appeal rights were given, and report was reviewed with Director, Joshua Reed.
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE: DATE: 11/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/16/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/16/2023 01:51 PM - It Cannot Be Edited


Created By: Ashley Curry On 11/16/2023 at 11:01 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: ALBANY CHILDREN'S CENTER
FACILITY NUMBER: 013420549

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
11/17/2023
Section Cited
CCR
101223(a)(3)

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101223Personal Rights(a)The licensee shall ensure..(3)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature...
This Requirement is not met as evidence by:
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By 11/17/2023 the Director will submit a written statement on how the facility will prevent a child's personal rights from being violated.
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Based on the interviews, the facility did not comply with the section cited above by ensuring staff handle children in an appropriate manner, which poses as an immediate risk to the health, safety, and personal rights of children in care
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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.
SUPERVISOR'S NAME:Loretta Dyson
LICENSING EVALUATOR NAME:Ashley Curry
LICENSING EVALUATOR SIGNATURE:
DATE: 11/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/16/2023


LIC809 (FAS) - (06/04)
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