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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700621
Report Date: 12/11/2025
Date Signed: 12/11/2025 02:12:50 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
10/27/2025 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20251027093642

FACILITY NAME:BUILDING KIDZ OF DUBLIN WESTFACILITY NUMBER:
015700621
ADMINISTRATOR:MUAZZAMA QURASHYFACILITY TYPE:
860
ADDRESS:7421 AMARILLO ROADTELEPHONE:
(925) 261-4193
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:24CENSUS: 12DATE:
12/11/2025
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Facility representative Carol AbeTIME COMPLETED:
02:00 PM
ALLEGATION(S):
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-The facility is not providing care and supervison to the children in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation. LPA met with Facility representative Carol Abe and explained the purpose of the inspection. Present for today's visit, there were Facility representative , and 3 fingerprint-cleared and associated staff members, and 12 children( 9 preschoolers and 3 toddlers) in care.
Based on the interview and the record review, including video footage provided by the facility, LPA determined that the incident occurred when a parent dropped off a child in the playground and left the playground door open. A child exited the playground area and ran toward the parking lot. A teacher retrieved the child and brought the child back to the facility. Therefore, the allegation is found to be SUBSTANTIATED. California Code of Regulations, {Title 22, Division 12, Chapter 1, Section 101229(a)(1) is being cited on the attached LIC 9099D.

Appeal rights were given and an exit interview was conducted with facility representative Carol Abe.

Notice of site visit was provided and must be posted for 30 days.



Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 7 of 8
Control Number 52-CC-20251027093642
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 WEST
FACILITY NUMBER: 015700621
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/11/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/19/2025
Section Cited
CCR
101229(a)(1)
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101229(a)(1) Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision as necessary to meet the children's needs.(1)No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
This requirement is not met as evidenced by:

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The facility shall ensure that all children remain within the supervised play area at all times. The facility shall submit a Plan of Correction to CCLD by the due date, identifying the measures that will be implemented and how the facility will prevent this type of incident from occurring in the future
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Based on observations, interviews, and record reviews, the Licensee did not comply with the cited section. An incident was identified in which a child was able to exit the playground area, and a teacher retrieved the child from the parking lot, which poses a potential risk to the health, safety, and personal rights 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: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 12/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/11/2025
LIC9099 (FAS) - (06/04)
Page: 8 of 8