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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 073400254
Report Date: 08/23/2023
Date Signed: 08/23/2023 12:48:45 PM

Document Has Been Signed on 08/23/2023 12:48 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME:CONTRA COSTA CO. HEAD START - LAVONIA ALLEN CENTERFACILITY NUMBER:
073400254
ADMINISTRATOR:DORIS STEPHENSFACILITY TYPE:
850
ADDRESS:94 1/2 MEDANOS AVENUETELEPHONE:
(925) 427-8270
CITY:BAY POINTSTATE: CAZIP CODE:
94565
CAPACITY: 48TOTAL ENROLLED CHILDREN: 13CENSUS: 11DATE:
08/23/2023
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH: Ligia OrtizTIME COMPLETED:
12:55 PM
NARRATIVE
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On 8/23/23, at 9:15am, Licensing Program Analysts (LPAs) Catherine Fernandes and Randal Dunevant arrived unannounced on a case management visit and met with staff member one, whom stated the Director was on the way. Soon after Assistant Director Jessie Black and Director Ligia Ortiz arrived. While at the center LPAs did a walk through of the center, interviewed the Directors and obtained documents regrading the incident.

The center self reported an incident to licensing that occurred on 8/11/23. There was an incident where a staff member raised their voice and made the child sit down on the bench while outside. The staff member was immediately put on administrative position outside of the center while the center conducts their investigation. Based on the incident there was a violation of personal rights.

LPAs Fernandes and Dunevant informed Director Ligia Ortiz that this report dated 8/23/23 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the personal rights of children in care.
Also, LPAs Fernandes and Dunevant informed the Director to provide a copy of this licensing report dated 8/23/23 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification. See 809D for the deficiency.

The center is conducting a staff training today to go over personal rights, center expectations and supervision.


Exit interview conducted with Director Ligia Ortiz.

Report, Appeal Rights and Notice of site visit provided.

SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Catherine Fernandes
LICENSING EVALUATOR SIGNATURE: DATE: 08/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/23/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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Document Has Been Signed on 08/23/2023 12:48 PM - It Cannot Be Edited


Created By: Catherine Fernandes On 08/23/2023 at 11:54 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: CONTRA COSTA CO. HEAD START - LAVONIA ALLEN CENTER
FACILITY NUMBER: 073400254

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/24/2023
Section Cited
CCR
101223(a)(3)

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The licensee shall ensure that each child is accorded the following personal rights: To be free.. unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse or other actions of a punitive nature .. This requirement has not been met as evidenced by:
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The center will conduct a staff training regarding personal rights of the children in care and submit a copy of the agenda to CCL.

*The citation has been cleared and the staff member is on administrative duties as of now.
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Based on the incident a child personal rights were violated which is an immediate 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.
SUPERVISOR'S NAME:Mayla Mendoza
LICENSING EVALUATOR NAME:Catherine Fernandes
LICENSING EVALUATOR SIGNATURE:
DATE: 08/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/23/2023


LIC809 (FAS) - (06/04)
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