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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 070213772
Report Date: 07/21/2021
Date Signed: 07/21/2021 03:44:38 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
05/03/2021 and conducted by Evaluator Lakeisha Chew
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210503083154
FACILITY NAME:CHILD'S PLACE PRESCHOOL & DAYCARE, AFACILITY NUMBER:
070213772
ADMINISTRATOR:HAYS, CAROLYNFACILITY TYPE:
850
ADDRESS:3405 MAIN STREETTELEPHONE:
(925) 625-9795
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:29CENSUS: 13DATE:
07/21/2021
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:HAYS, CAROLYNTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS - Staff threatened day care child.
INVESTIGATION FINDINGS:
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5
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10
11
12
13
On July 21, 20201, Licensing Program Analyst (LPA) L. Chew and Licensing Program Manager (LPM) L. Dyson conducted an unannounced complaint inspection. LPA and LPM met with Owner/Director HAYS, CAROLYN regarding the above allegation. Owner/Director was advised of purpose of today’s inspection.

Upon arrival Director/Owner state present were 13 children in care and 2 staff members which includes Owner/Director. Shortly after census was provide 1 additional staff member arrived to facility. LPA and LPM was advised facility was closing due to an Emergency. During the investigation, observations was made, interviews conducted, and records obtained. Evidence supports the allegation that Owner/Director threaten to call the police on a child in care, as a form of discipline. Based on the evidence Owner/Director admitted to allegation and other witnesses also supports that the allegation is true. The preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
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
Control Number 02-CC-20210503083154
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: CHILD'S PLACE PRESCHOOL & DAYCARE, A
FACILITY NUMBER: 070213772
VISIT DATE: 07/21/2021
NARRATIVE
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California Code of Regulations (CCR), (Title 22, Section 101223(a)(3), is being cited on the attached LIC 9099-D. This report will remain on file for 3 years.

An exit interview was conducted. LPA and LPM discussed and reviewed the reports and appeal rights with Owner/Director. A copy of the reports, Appeal Rights and Notice of Site Visit was provided to Owner/Director. Owner/Director was reminded to post this report and Notice of Site Visit for 30 days in public view.



Owner/Director acknowledges that for Type A Deficiencies only upon receipt, the Owner/Director shall post the LIC 9099-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/ guardians of children newly enrolled at the facility during the next 12 months.

The LIC 9224 must be signed by parents/ guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Owner/Director. A copy of the LIC 9224 was provided to Owner/Director.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 7
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
05/03/2021 and conducted by Evaluator Lakeisha Chew
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210503083154

FACILITY NAME:CHILD'S PLACE PRESCHOOL & DAYCARE, AFACILITY NUMBER:
070213772
ADMINISTRATOR:HAYS, CAROLYNFACILITY TYPE:
850
ADDRESS:3405 MAIN STREETTELEPHONE:
(925) 625-9795
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:29CENSUS: 13DATE:
07/21/2021
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:HAYS, CAROLYNTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS - Day care child was not accorded dignity in relationships with staff.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 21, 20201, Licensing Program Analyst (LPA) L. Chew and Licensing Program Manager (LPM) L. Dyson conducted an unannounced complaint inspection. LPA and LPM met with Owner/Director HAYS, CAROLYN regarding the above allegation. Owner/Director was advised of purpose of today’s inspection.
Upon arrival Director/Owner state present were 13 children in care and 2 staff members which includes Owner/Director. Shortly after census was provide 1 additional staff member arrived to facility. LPA and LPM was advised facility was closing due to an Emergency. During the investigation, observations was made, interviews conducted, and records obtained. Evidence supports the allegation that Daycare child was not accorded dignity in relationships with staff, as a form of discipline. Based on the evidence Owner/Director admitted to throwing a child belongings away in a trashcan as a form of discipline. Other witnesses also support that the allegation is true. The preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
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 7
Control Number 02-CC-20210503083154
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: CHILD'S PLACE PRESCHOOL & DAYCARE, A
FACILITY NUMBER: 070213772
VISIT DATE: 07/21/2021
NARRATIVE
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2
3
4
5
6
7
8
9
10
11
12
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15
16
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27
28
29
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31
32
California Code of Regulations (CCR), (Title 22, Section 101223(a)(1), is being cited on the attached LIC 9099-D. This report will remain on file for 3 years.

An exit interview was conducted. LPA and LPM discussed and reviewed the reports and appeal rights with Owner/Director. A copy of the reports, Appeal Rights and Notice of Site Visit was provided to Owner/Director. Owner/Director was reminded to post this report and Notice of Site Visit for 30 days in public view.



Owner/Director acknowledges that for Type A Deficiencies only upon receipt, the Owner/Director shall post the LIC 9099-D with Type A deficiencies for 30 days and provide copies of this licensing report to parents/guardians of children in care at the facility and to parents/ guardians of children newly enrolled at the facility during the next 12 months.

The LIC 9224 must be signed by parents/ guardians and kept with the children's forms as a receipt whenever any Type A documents are provided by the Owner/Director. A copy of the LIC 9224 was provided to Owner/Director.

SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC9099 (FAS) - (06/04)
Page: 4 of 7
Control Number 02-CC-20210503083154
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: CHILD'S PLACE PRESCHOOL & DAYCARE, A
FACILITY NUMBER: 070213772
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2021
Section Cited
CCR
101223(a)(1)
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Personal Rights 101223(a)(1). - (a) The licensee shall ensure that each child is accorded the following personal rights:
(1) To be accorded dignity in his/her personal relationships with staff and other persons.
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By 7/22/2021 Owner/Director will submit a training plan to indicate what training Owner/Director and staff members will complete, related to Personal Rights and Discipline in childcare, within the next 30 days.
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This requirement was not met as evidenced by Owner/Director admitting to throwing away a child’s belongings as a form of discipline. This poses an immediate risk for the health and safety of children in care.
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9
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Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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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: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC9099 (FAS) - (06/04)
Page: 5 of 7
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
05/03/2021 and conducted by Evaluator Lakeisha Chew
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20210503083154

FACILITY NAME:CHILD'S PLACE PRESCHOOL & DAYCARE, AFACILITY NUMBER:
070213772
ADMINISTRATOR:HAYS, CAROLYNFACILITY TYPE:
850
ADDRESS:3405 MAIN STREETTELEPHONE:
(925) 625-9795
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:29CENSUS: 13DATE:
07/21/2021
UNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:HAYS, CAROLYNTIME COMPLETED:
04:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS - Staff pinched day care child.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 21, 20201, Licensing Program Analyst (LPA) L. Chew and Licensing Program Manager (LPM) L. Dyson conducted an unannounced complaint inspection. LPA and LPM met with Owner/Director HAYS, CAROLYN regarding the above allegation. Owner/Director was advised of purpose of today’s inspection. Upon arrival Director/Owner state present were 13 children in care and 2 staff members which includes Owner/Director. Shortly after census was provide 1 additional staff member arrived to facility. LPA and LPM was advised facility was closing due to an Emergency. During the investigation, observations was made, interviews conducted, and records obtained. Based on information obtained there is not a preponderance of evidence to substantiate the allegation, therefore the allegation is UNSUBSTANTIATED which means that although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation occurred. There are no deficiencies being cited today. This report will remain on file for 3 years. An exit interview was conducted. LPA and LPM discussed and reviewed the reports and appeal rights with Owner/Director. A copy of the reports and appeal rights was provided to Owner/Director. Owner/Director was provided a Notice of Site Visit and reminded to have form posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 6 of 7
Control Number 02-CC-20210503083154
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: CHILD'S PLACE PRESCHOOL & DAYCARE, A
FACILITY NUMBER: 070213772
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/21/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/22/2021
Section Cited
CCR
101223(a)(3)
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2
3
4
5
6
7
Personal Rights 101223(a)(3). - (a) The licensee shall ensure that each child is accorded the following personal rights: (3) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, actions of a punitive nature, coercion, threat, mental abuse
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By 7/22/2021 Owner/Director will watch Personal Rights Video and submit a written statement acknowledging her understanding of and her agreement to abide by Title 22 Regulations
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This requirement was not met as evidenced by Owner/Director admitting to threatening to call a police on a daycare child. as a form of discipline. This poses an immediate risk for the health and safety of children in care.

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9
10
11
12
13
14
Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
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3
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7
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5
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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: Loretta Dyson
LICENSING EVALUATOR NAME: Lakeisha Chew
LICENSING EVALUATOR SIGNATURE:

DATE: 07/21/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2021
LIC9099 (FAS) - (06/04)
Page: 7 of 7