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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422427
Report Date: 09/19/2024
Date Signed: 07/24/2025 04:15:09 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
07/11/2024 and conducted by Evaluator April Wright
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20240711135628
FACILITY NAME:KIDDIE ACADEMYFACILITY NUMBER:
013422427
ADMINISTRATOR:JENNY PAIFACILITY TYPE:
830
ADDRESS:1400 N. VASCO RD.TELEPHONE:
(925) 292-1948
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:24CENSUS: 13DATE:
09/19/2024
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Sarah De SousaTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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2
3
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5
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7
8
9
Personal Rights - Child sustained an injury while in care.
INVESTIGATION FINDINGS:
1
2
3
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5
6
7
8
9
10
11
12
13
***Amended to change type A to type B for the personal rights violation based on an appeal decision***

On September 23rd, 2024 at 9:20am, Licensing Program Analyst (LPA) April Wright and Licensing Program Manager (LPM) Chandra Charles met with Center Director Sarah De Sousa and Regional Director Nickole Kirbyson for an unannounced complaint inspection to amend complaint investigation findings. Present during the inspection were 7 infant children and 3 fingerprint cleared staff personnel at the facility. A health and safety inspection was conducted by the LPA, LPM and facility management staff.

During the course of the investigation, LPA interviewed staff personnel, interviewed a random sample of parents, reviewed staff & children facility files, and reviewed photographs/video footage of the infant care classroom. The complaint alleges a child’s Personal Right’s were violated – Day-care child sustained injuries while in care. This agency has investigated this complaint.
See LIC9099C for continuance.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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 7
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 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
07/11/2024 and conducted by Evaluator April Wright
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20240711135628

FACILITY NAME:KIDDIE ACADEMYFACILITY NUMBER:
013422427
ADMINISTRATOR:JENNY PAIFACILITY TYPE:
830
ADDRESS:1400 N. VASCO RD.TELEPHONE:
(925) 292-1948
CITY:LIVERMORESTATE: CAZIP CODE:
94551
CAPACITY:24CENSUS: 13DATE:
09/19/2024
UNANNOUNCEDTIME BEGAN:
11:35 AM
MET WITH:Sarah De SousaTIME COMPLETED:
02:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Lack of Supervision - Staff did not ensure supervision was provided to children in care
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On September 23rd, 2024 at 9:20am, Licensing Program Analyst (LPA) April Wright and Licensing Program Manager (LPM) Chandra Charles met with Center Director Sarah De Sousa and Regional Director Nickole Kirbyson for an unannounced complaint inspection to amend complaint investigation findings. Present during the inspection were 7 infant children and 3 fingerprint cleared staff personnel at the facility. A health and safety inspection was conducted by the LPA, LPM and facility management staff.

During the course of the investigation, LPA interviewed staff personnel, interviewed a random sample of parents, reviewed staff & children facility files, and reviewed photographs/video footage of the infant care classroom. The complaint alleges a Lack of Supervision - Staff did not ensure supervision was provided to children in care. This agency has investigated this complaint.

Based on interviews that were conducted by the LPA, photographs/video footage received and reviewed, and documentation that was received during the investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. See LIC9099C for continuance.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
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 52-CC-20240711135628
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDDIE ACADEMY
FACILITY NUMBER: 013422427
VISIT DATE: 09/19/2024
NARRATIVE
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5
6
7
8
9
10
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32
California Code of Regulations, Title 22, Division 12 Chapter 1 Article 06 Section 101429(a)(1) is being cited as a Type A Violation. See the attached LIC 9099D for details of the regulations that were violated and cited. LPA provided the LIC9224 for the Center Director to give to current families by 9/24/2024 and all new families for a 12 month period, effective 9/24/2024. This report must remain on file for three years.


Report was read, reviewed and exit interview was conducted with Center Director Sarah De Sousa. Appeal rights were given and discussed with the Center Director.
SUPERVISORS NAME: Chandra Charles
LICENSING EVALUATOR NAME: April Wright
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 7
Control Number 52-CC-20240711135628
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: KIDDIE ACADEMY
FACILITY NUMBER: 013422427
VISIT DATE: 09/19/2024
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
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14
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16
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32
****Amended to change type A to type B for the personal rights violation based on an appeal decision****

Based on interviews that were conducted by the LPA, photographs/video footage received and reviewed, and documentation that was received during the investigation, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Report was read, reviewed and exit interview was conducted with Center Director Sarah De Sousa. Appeal rights were given and discussed with the Center Director.
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 52-CC-20240711135628
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: KIDDIE ACADEMY
FACILITY NUMBER: 013422427
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/19/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/20/2024
Section Cited
HSC
101429(a)(1)
1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision for Infants (a) In addition to Section 101429, the following shall apply:(1) Each infant shall be constantly supervised and under direct visual observation and supervision by a staff person at all times. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Center Director will install additional mirrors to provide visual supervision to infants in care.. Center Director will submit proof of installation to LPA Wright by end of business on 9/24/2024.
8
9
10
11
12
13
14
LPA reviewed video footage provided by facility which show teachers not providing visual supervision to infants in care, which poses a immediate risk to the health, safety, and personal rights of the children in care
8
9
10
11
12
13
14
Type B
09/20/2024
Section Cited
CCR
101223(a)(2)
1
2
3
4
5
6
7
Personal Rights - 101223(a)(2) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
This requirement is not met as evidenced by:
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2
3
4
5
6
7
Center director and staff shall watch the "Personal Rights" Video on the CCLD website. Center Director will have written plan for providing supervision to children in care. Center Director will submit proof the written plan to LPA Wright by end of business on 9/24/2024.
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Based on interviews, record review and photographs/video footage received, Facility did not comply with the section cited above. where a child was bitten and sustained an injury requiring medical attention. which posed a potential risk to the health, safety, and personal rights of the children in care.
8
9
10
11
12
13
14
****Amended to change type A to type B for the personal rights violation based on an appeal decision****
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: Jaleesa Jackson
LICENSING EVALUATOR SIGNATURE:

DATE: 09/19/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2024
LIC9099 (FAS) - (06/04)
Page: 7 of 7