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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422427
Report Date: 03/22/2023
Date Signed: 03/22/2023 02:04:23 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 STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/14/2023 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20230214145021

FACILITY NAME:KIDDIE ACADEMYFACILITY NUMBER:
013422427
ADMINISTRATOR:BRUCE, SHANNONFACILITY TYPE:
830
ADDRESS:1400 N. VASCO RD.TELEPHONE:
(925) 292-1948
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:24CENSUS: 16DATE:
03/22/2023
UNANNOUNCEDTIME BEGAN:
12:19 PM
MET WITH:Kimberly KotasTIME COMPLETED:
02:03 PM
ALLEGATION(S):
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Personal Rights - Daycare child sustained diaper rash while in care
INVESTIGATION FINDINGS:
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At 12:19pm on 3/22/2023 Licensing Program Analyst (LPA) Morgan Pringle met with Regional Director Kimberley Kotas and Regional Support Specialist Stephanie Beltram to deliver findings for a complaint that was received against the facility alleging a child sustained a diaper rash while in care. During LPA's visit two classrooms (Butterflies and Catapillars) were inspected. Present during LPA's visit were sixteen (16) infants and three (3) staff. Eight (8) of the children in the Butterflies classroom were sleeping. LPA obtained the personnel roster and two (2) staff files.

During the course of LPA's investigation interviews were conducted, LPA toured the facility and obtained facility documents and conducted file reviews. LPA determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 is being cited on the attached LIC 9099D. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in civil penalties. A notice of site visit and appeal rights were given. Exit interview conducted and report was reviewed with Kimberley Kotas.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
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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Control Number 52-CC-20230214145021
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: 013422427
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/22/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/24/2023
Section Cited
CCR
101223(a)(3)
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(a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from...other actions of a punitive nature including but not limited to: interference with functions of daily living including...toileting; or withholding of...aids to physical functioning.
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A written plan of action will be submitted to LPA Pringle detailing steps staff will take to verify that the diapering needs of children in care are being met.
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This requirement was not met as evidence by: a child's personal rights were violated when facility staff failed to change a child's diaper which resulted in a diaper rash. This poses a potential risk to the health and safety of the 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: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 03/22/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/22/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3