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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013421551
Report Date: 10/23/2024
Date Signed: 10/23/2024 12:01:23 PM

Substantiated


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
08/28/2024 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20240828101424
FACILITY NAME:DAY, ESSIEFACILITY NUMBER:
013421551
ADMINISTRATOR:DAY, ESSIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 567-3339
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY:14CENSUS: 7DATE:
10/23/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Shayna JoinerTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Provider did not provide adequate supervision to children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cherie Acosta and Kayla Merchant conducted an unannounced visit to close the complaint. LPAs first met with Shayna Joiner and later with Ann Williams. Ann Williams is the licensee's mother.

Licensee and staff stated that on 8/27/24 children were playing in the backyard. Two young children wandered away from the group, walked up the side of the house to the front yard without staff knowledge. The children opened the gate which exits the property. Staff stated that one of the staff members was returning from her break as the children were opening the gate and prevented children from exiting the property.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
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 3
Control Number 02-CC-20240828101424
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: DAY, ESSIE
FACILITY NUMBER: 013421551
VISIT DATE: 10/23/2024
NARRATIVE
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Based on interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.

LPA's reviewed the report with Ann Williams. the report was also reviewed with licensee over the telephone.

Notice of Site Visit was provided and must be posted for 30 days.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20240828101424
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: DAY, ESSIE
FACILITY NUMBER: 013421551
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/30/2024
Section Cited
CCR
102417(a)
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Operation of a Family Child Care Home.The licensee shall be present in the home and shall ensure that children in care are supervised at all times. When circumstances require the licensee to be temporarily absent from the home, the licensee shall arrange
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Licensee shall develop a written plan of action to ensure children have adequate supervision at all times. Licensee shall submit a copy of this plan to CCL by 10/30/24.
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for a substitute adult to care for and supervise the children during his/her absence. Temporary absences shall not exceed 20 percent of the hours that the facility is providing care per day.This requirement was not met as evidenced by: two children wandered away from staff and were unsupervised which is a potential risk to the health and safety of 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: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 10/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/23/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3