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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422461
Report Date: 04/06/2021
Date Signed: 04/06/2021 01:32:59 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
03/30/2021 and conducted by Evaluator Brittany Newton
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210330093806
FACILITY NAME:GOLDEN GATE LEARNING CENTERFACILITY NUMBER:
013422461
ADMINISTRATOR:TABIQUE, MELISSAFACILITY TYPE:
850
ADDRESS:1450 SIXTH STTELEPHONE:
(510) 366-9260
CITY:BERKELEYSTATE: CAZIP CODE:
94710
CAPACITY:45CENSUS: 18DATE:
04/06/2021
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Melissa TabiqueTIME COMPLETED:
02:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child sustained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 04/06/2021, Licensing Program Analyst (LPA) Brittany Newton conducted an unannounced visit for the purpose of opening a complaint investigation. LPA was met by director Melissa Tabique. Present for the inspection was 8 toddlers and 10 preschoolers.

Over the course of the investigation LPA interviewed staff and reviewed documentation. Interviews conducted didn't verify that the child mentioned in the complaint sustained injuries while in care therefore the allegation is Unsubstantiated meaning that the information mentioned in the allegation may be valid, but there isn't a preponderance of evidence present, therefore the complaint is unsubstantiated. Exit interview conducted, appeal rights provided and a copy of this report was left with director Melissa Tabique.
Unsubstantiated
Estimated Days of Completion: 0
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Brittany Newton
LICENSING EVALUATOR SIGNATURE:

DATE: 04/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/06/2021
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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