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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422004
Report Date: 09/27/2023
Date Signed: 09/27/2023 03:21:10 PM

Unsubstantiated


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
09/12/2023 and conducted by Evaluator Ashley Curry
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230912092558
FACILITY NAME:OUSD - ARROYO VIEJO CDCFACILITY NUMBER:
013422004
ADMINISTRATOR:JOY FORTE`FACILITY TYPE:
850
ADDRESS:1895 - 78TH AVETELEPHONE:
(510) 636-1254
CITY:OAKLANDSTATE: CAZIP CODE:
94621
CAPACITY:72CENSUS: 37DATE:
09/27/2023
UNANNOUNCEDTIME BEGAN:
12:15 PM
MET WITH:Lynn Pfeiffer/Caroline JonesTIME COMPLETED:
03:30 PM
ALLEGATION(S):
1
2
3
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5
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7
8
9
Staff left daycare child in soiled pull-up.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 09/27/2023 at 12:15 PM Licensing Program Analyst (LPA), A. Curry conducted an unannounced subsequent complaint inspection. LPA met with Lead Teaher, Lynn Pfeiffer, to explain the purpose of today's visit. The Site Principal, Caroline Jones, arrived during the visit. LPA toured the facility, made observations, conducted interviews, and reviewed relevant documentation. The allegation is staff left daycare child in soiled pull-up. Based on information gathered through diapering logs and interviews, children pull-ups are changed frequently. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove that the alleged violation did or did not occur. This allegation is Unsubstantiated. No deficiencies are being cited.

Exit interview conducted, appeal rights were given, and report was reviewed with the Site Principal, Caroline Jones.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
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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