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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700583
Report Date: 06/04/2025
Date Signed: 06/04/2025 01:57:12 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
04/09/2025 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20250409115521
FACILITY NAME:BUILDING KIDZ OF DUBLINFACILITY NUMBER:
015700583
ADMINISTRATOR:SHUBRA GUPTAFACILITY TYPE:
850
ADDRESS:6351 DUBLIN BOULEVARDTELEPHONE:
(650) 777-5301
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:60CENSUS: 45DATE:
06/04/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Shubra Gupta TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Licensee did not ensure required records were maintained for day care children.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with Director Shubra Gupta and explained the purpose of the inspection. The director, assistant director, seven (7) staff members, and 45 children in care were present for today's visit.
Based on interviews, record reviews, and observations, the Licensing Program Analyst (LPA) determined that the files maintained for children C1 and C2 are missing respective physician’s report (LIC 701). Furthermore, the records indicate that there is no file associated with the facility for C3 which concludes that facility did not ensure required records in children’s files. The preponderance of evidence standard has been met; therefore, the allegation is found to be SUBSTANTIATED. California Code of Regulations, {Title 22, Division 12, Chapter 1, Section 101221(a) is being cited on the attached LIC 9099D
Appeal rights were given.
An exit interview was conducted, and the report was reviewed with the Director,Shubra Gupta.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
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 5
Control Number 52-CC-20250409115521
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: BUILDING KIDZ OF DUBLIN
FACILITY NUMBER: 015700583
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/13/2025
Section Cited
CCR
101221(a)
1
2
3
4
5
6
7
101221 Child's Records
(a) A separate, complete and current record for each child is maintained in the child care center.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The center shall ensure that children's files are updated and complete. The center shall submit any missing documents to LPA by 06/13/2025. The facility shall also provide a written statement indicating that all children's files have been completed. Follow up visit might be conducted.
8
9
10
11
12
13
14
Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above, which poses a potential risk to the health, safety, and personal rights of the children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
04/09/2025 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20250409115521

FACILITY NAME:BUILDING KIDZ OF DUBLINFACILITY NUMBER:
015700583
ADMINISTRATOR:SHUBRA GUPTAFACILITY TYPE:
850
ADDRESS:6351 DUBLIN BOULEVARDTELEPHONE:
(650) 777-5301
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:60CENSUS: 45DATE:
06/04/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Shubra Gupta TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Staff directed other staff to make false statements to Licensing.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with Director Shubra Gupta and explained the purpose of the inspection. The director, assistant director, seven (7) staff members, and 45 children in care were present for today's visit.
Based on interviews, record reviews, and observations, there is no information indicating that staff were asked or instructed to make false statements to licensing leading to the conclusion that while the allegation may have occurred or is valid, there is no preponderance of evidence to prove the alleged violation. Therefore, the allegation is "Unsubstantiated."

Appeal Rights were provided.
An exit interview was conducted, and the report was reviewed with the Director, Shubra Gupta.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
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
04/09/2025 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20250409115521

FACILITY NAME:BUILDING KIDZ OF DUBLINFACILITY NUMBER:
015700583
ADMINISTRATOR:SHUBRA GUPTAFACILITY TYPE:
850
ADDRESS:6351 DUBLIN BOULEVARDTELEPHONE:
(650) 777-5301
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:60CENSUS: 45DATE:
06/04/2025
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Director, Shubra Gupta TIME COMPLETED:
12:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-The facility falsify staff record.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with Director Shubra Gupta and explained the purpose of the inspection. The director, assistant director, seven (7) staff members, and 45 children in care were present for today's visit.
Based on record reviews and observations, the Licensing Program Analyst (LPA) Saini has determined that the files maintained for S1 and S2 contain mandated reporter certificates that were not legitimately completed by them. The preponderance of evidence standard has been met; therefore, the allegation is found to be SUBSTANTIATED. California Code of Regulations, {Title 22, Division 12, Chapter 1, Section 101206(a)(c) is being cited on the attached LIC 9099D
Appeal rights were given.
An exit interview was conducted, and the report was reviewed with the Director,Shubra Gupta.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Citations on this Visit Report are Under Appeal!

Control Number 52-CC-20250409115521
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: BUILDING KIDZ OF DUBLIN
FACILITY NUMBER: 015700583
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/04/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Under Appeal
Type B
06/06/2025
Section Cited
CCR
101206(a)(c)
1
2
3
4
5
6
7
101206 Revocation or Suspension of License (a)The Department has the authority to suspend or revoke a license on any of the grounds specified in Health and Safety Code Section 1596.885. (c) Conduct which is inimical to the health, morals, welfare, or safety of either an individual in or receiving services from the facility or the people of this state.
This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The Director shall submit a written statement detailing corrective actions to uphold proper recordkeeping procedures. Additionally, the facility will verify that all staff members Mandated Reporter certificates belongs to them.
8
9
10
11
12
13
14
Based on observations, interviews, and record reviews, the Licensee did not comply with the section cited above, which poses a potential risk to the health, safety, and personal rights of the children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2025
LIC9099 (FAS) - (06/04)
Page: 5 of 5