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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422425
Report Date: 06/24/2021
Date Signed: 06/24/2021 10:44:37 AM

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 STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
06/24/2021 and conducted by Evaluator Jaylena Miller
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20210624092248
FACILITY NAME:KIDDIE ACADEMYFACILITY NUMBER:
013422425
ADMINISTRATOR:BRUCE, SHANNONFACILITY TYPE:
850
ADDRESS:1400 N. VASCO RD.TELEPHONE:
(925) 292-1948
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:120CENSUS: 46DATE:
06/24/2021
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Marquita GladneyTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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Personal Rights- Teacher hit daycare child
INVESTIGATION FINDINGS:
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On 6/24/2021 at 9:00am Licensing Program Analyst (LPA) Jaylena Miller conducted an unannounced 10 day complaint investigation regarding the above allegation and met with Director Marquita Gladney and the explained the purpose of the visit. Present for the inspection were 6 staff and 46 preschool children. The facility is within ratio today.

During the investigation LPA Miller conducted an interview with Director. Director stated that S1 did admit to hitting C1 during nap time. Director also called in an unusual incident report within a timely manner and submitted a written LIC 624 to the department.

Based on LPA Miller’s interviews which were conducted, and records reviewed, the preponderance of evidence standard has been met, therefor the above allegation is to be SUBSTANTIATED. As a result, and per California Code of Regulations, Title 22 Division 12, Chapter 1, Section 101223(a)(3) is being cited on LIC 9099-D.
The director must post this report for thirty days.

Please see LIC 9099-C for continuance
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
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 52-CC-20210624092248
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 STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDDIE ACADEMY
FACILITY NUMBER: 013422425
VISIT DATE: 06/24/2021
NARRATIVE
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The director must give each parent of the children in care and future parents of newly enrolled children, for the next one year, a copy of this report. Parents are to sign an LIC 9224 (Acknowledgment of Receipt of Licensing reports) and this form shall be placed in each child’s file. Failure to post report and or provide a copy of this report to parent’s/authorized guardians can result in monetary assessments to the facility.

This report must remain on file for three years. The director was provided a copy of their appeal rights (LIC 9058 12/15) and their signature on this form acknowledges receipt of these rights. Notice of site visit was provided and must be posted for thirty days. Exit interview conducted with director, Marquita Gladney.

Please see LIC 9099-D for deficiency cited
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 52-CC-20210624092248
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 STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDDIE ACADEMY
FACILITY NUMBER: 013422425
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/24/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
06/24/2021
Section Cited
CCR
101223(a)(3)
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101223(a)(3) Personal Rights
(a)The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain… This requirement was not met as evidence by:
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Director will have an all staff training of Children’s Personal Rights and de-escalation/redirection and provide LPA with a sign-in sheet. All staff will watch a video from the departments website title “Children’s Personal Rights in Child care and provide LPA with written summary by 6/25/2021.
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Based on staff interviews S1 did not ensure C1s safety when she hit him and violated his personal rights, which poses an immediate risk to the health and safety 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.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE:

DATE: 06/24/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/24/2021
LIC9099 (FAS) - (06/04)
Page: 3 of 3