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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013420964
Report Date: 09/17/2025
Date Signed: 09/17/2025 03:46:00 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
08/15/2025 and conducted by Evaluator Catherine Fernandes
COMPLAINT CONTROL NUMBER: 02-CC-20250815105128

FACILITY NAME:BERKELEY YMCA HEAD START - EMERYVILLE MARINAFACILITY NUMBER:
013420964
ADMINISTRATOR:WILLIAMS, ROCHELLE LA'RUEFACILITY TYPE:
830
ADDRESS:1275 - 61ST STTELEPHONE:
(510) 601-8674
CITY:EMERYVILLESTATE: CAZIP CODE:
94608
CAPACITY:40CENSUS: DATE:
09/17/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Rochelle La'Rue WilliamsTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Staff did not report incident to infant’s responsible party in a timely manner.
INVESTIGATION FINDINGS:
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On 9/17/25, at 1:00PM, Licensing Program Analyst (LPA) Catherine Fernandes arrived unannounced to deliver the finding to the above allegation and met with Rochelle La'Rue Williams. Present in care were nine infants and 18 toddlers with an additional 10 staff members. During the investigation LPA Fernandes conducted interviews, observed the classroom, reviewed center documentation regarding the allegation and did a walk through of the center.
Based on one particular injury, a parent was called at the time of the incident however, staff only attempted to contact the parent one time and was unable to leave a message. According to the center's injury policy if the parent can not be contacted then the emergency contact needs to be called. The staff did not call the child's emergency contacts and the parent was informed about three hours later. Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met. Title 22, California Code of Regulations are being cited on the attached LIC 9099D.

Exit interview conducted with Director. Appeal Rights, Report, Notice of Site visit provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 7
Control Number 02-CC-20250815105128
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: BERKELEY YMCA HEAD START - EMERYVILLE MARINA
FACILITY NUMBER: 013420964
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/17/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/08/2025
Section Cited
CCR
101212(f)
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Reporting Requirements: The items specified in (d)(1)(A) through (H) above shall also be reported to the child's authorized representative. This requirement has not been met as evidenced by:
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The center will conduct a staff training on reporting requirement regulations and the YMCA injury policy procedures then send a list of attending staff members and an agenda list to CCLD by POC date.
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Based on interviews and the center documentation, the center did not follow the center policies on reporting injuries and they did not report the incident to the parent in a timely manner, which is a potential risk to 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.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 09/17/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/17/2025
LIC9099 (FAS) - (06/04)
Page: 3 of 7