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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 013422484
Report Date: 08/15/2023
Date Signed: 08/15/2023 02:05:43 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, SUITE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
07/19/2023 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230719130702
FACILITY NAME:UNITY COUNCIL CHILD CENTERFACILITY NUMBER:
013422484
ADMINISTRATOR:ELIZABETH CROCKERFACILITY TYPE:
830
ADDRESS:2615 E 15TH STTELEPHONE:
(510) 535-2760
CITY:OAKLANDSTATE: CAZIP CODE:
94601
CAPACITY:30CENSUS: 10DATE:
08/15/2023
UNANNOUNCEDTIME BEGAN:
12:53 PM
MET WITH:Zenaida BarajasTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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Staff did not notify day care child's Authorized Representative of child's injury in a timely manner.
INVESTIGATION FINDINGS:
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On 8/15/23, at 12:53PM, Licensing Program Analysts (LPAs) Catherine Fernandes and Randall Dunevant arrived unannounced to deliver the findings to the above allegation and met with Director Zenaida Barajas. Present in care were four infants, nine toddlers and nine additional staff members. During the investigation LPA Fernandes conducted interviews with parents and staff, observed the classrooms, reviewed center documentation regarding the allegation and did a walk through of the center.

There was an incident involving a child getting hurt while at the center that involved the child falling on their face and injuring their arm. The center's policy and procedures are to call parents when any head or face incidents occur or an accident that may require follow up by a health professional. Interviews indicated the center did not call the parent and instead provided a written report at the end of the day.
Therefore, the allegation is SUBSTANTIATED, the preponderance of evidence standard has been met.
Title 22, California Code of Regulations is being cited on the attached LIC 9099 D.
Exit interview conducted
Report and Appeal Rights provided
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
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 4
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
07/19/2023 and conducted by Evaluator Catherine Fernandes
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230719130702

FACILITY NAME:UNITY COUNCIL CHILD CENTERFACILITY NUMBER:
013422484
ADMINISTRATOR:ELIZABETH CROCKERFACILITY TYPE:
830
ADDRESS:2615 E 15TH STTELEPHONE:
(510) 535-2760
CITY:OAKLANDSTATE: CAZIP CODE:
94601
CAPACITY:30CENSUS: DATE:
08/15/2023
UNANNOUNCEDTIME BEGAN:
12:53 PM
MET WITH:TIME COMPLETED:
02:15 PM
ALLEGATION(S):
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9
Day care child sustained an injury due to lack of adequate supervision.
INVESTIGATION FINDINGS:
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On 8/15/23, at 12:53PM, Licensing Program Analysts (LPAs) Catherine Fernandes and Randall Dunevant arrived unannounced to deliver the findings to the above allegation and met with Director Zenaida Barajas. Present in care were four infants, nine toddlers and nine additional staff members. During the investigation LPA Fernandes conducted interviews with parents and staff, observed the classrooms, reviewed center documentation regarding the allegation and did a walk through of the center.

LPA Fernandes attempted to interview the staff member who may have witnessed the fall, however there was no communication from the staff member. Therefore, the allegation is unsubstantiated, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur.

Exit interview conducted
Report and Appeal provided
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
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 4
Control Number 02-CC-20230719130702
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, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: UNITY COUNCIL CHILD CENTER
FACILITY NUMBER: 013422484
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/31/2023
Section Cited
CCR
101218.1(a)(2)(B)
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Provides the child's parent or authorized representative with procedures to be followed should the child become ill or injured while at the child care center, and procedures for conducting inspections for illness. This requirement was not met as evidenced by:
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The center is to come up with a written plan to ensure all policies and procedures are followed by all staff members and then send the plan to CCL by POC date.
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Based on the child's accident and injury the center failed to abide by the procedures and policies by contacting the parent, which is a potential safety risk to 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: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:

DATE: 08/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/15/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4