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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073405625
Report Date: 02/03/2026
Date Signed: 02/03/2026 04:41:45 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
01/09/2026 and conducted by Evaluator Morgan Pringle
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20260109101442
FACILITY NAME:OLD FIREHOUSE SCHOOL WALNUT CREEKFACILITY NUMBER:
073405625
ADMINISTRATOR:JUDY HAUSFACILITY TYPE:
850
ADDRESS:55 ECKLEY LANETELEPHONE:
(925) 934-1507
CITY:WALNUT CREETSTATE: CAZIP CODE:
94596
CAPACITY:45CENSUS: 33DATE:
02/03/2026
UNANNOUNCEDTIME BEGAN:
03:07 PM
MET WITH:Judy HausTIME COMPLETED:
04:41 PM
ALLEGATION(S):
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Reporting Requirements - Staff did not properly report incidents to child's authorized representative
INVESTIGATION FINDINGS:
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On 2/3/2026 Licensing Program Analyst (LPA) Morgan Pringle met with Director Judy Haus to deliver findings for a complaint that was received alleging staff did not properly report incidents to child's authorized representative. Present during LPAs visit were thirty-three (33) preschool age children and six (6) additional staff members. Director left around 3:20pm and report was concluded with a facility staff member. The facility is located on the Mount Diablo Unitarian Universalist Church grounds and operates from 8:00am - 5:00pm in three (3) rooms, Yellow, Lavender and Firetruck.

During the complaint investigation interviews and observations were conducted and documents were collected. It was found that on 10/13/2025 a child sustained a minor scratch on the face while in care. Staff created an incident report for the child's parents, but misplaced it and it was not given to the parents at pick up time.

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
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 3
Control Number 02-CC-20260109101442
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: OLD FIREHOUSE SCHOOL WALNUT CREEK
FACILITY NUMBER: 073405625
VISIT DATE: 02/03/2026
NARRATIVE
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The next morning, the report was given and a conversation was had with the child's parents. Interviews conducted stated that the scratch was discovered after nap time by a staff member, but had faded away by pick up time and was discovered by the child's parents when they returned home. It was stated that the staff member apologized for not giving the report to the child's parents at the appropriate time during the conversation that was had.

LPA determined the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22 is being cited on the attached LIC 9099D. Failure to submit Proof of Corrections (POC) by Plan of Correction date may result in civil penalties.

A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with facility staff member.

SUPERVISORS NAME: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20260109101442
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: OLD FIREHOUSE SCHOOL WALNUT CREEK
FACILITY NUMBER: 073405625
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/03/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/06/2026
Section Cited
CCR
101226(a)(2)
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101226(a)(2) In the case of less serious injuries including, but not limited to, minor cuts, scratches...requiring assessment and/or administration of first aid...the licensee shall document the injury...and notify the child's authorized representative... when the child is picked up from the center.
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Director must send LPA Pringle a statement explaining the facilities injury reporting procedure for minor injuries. Director will also give a copy of the written procedure to all staff and have each staff member sign the written notice.
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This requirement was not met as evidenced by: through interview it was found that a child sustained a minor scratch and the parents were not notified at pick up time. This poses a potential risk to the health, safety, and personal rights of children in care.
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Director will send LPA Pringle a copy of all signed copies by POC date.
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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: Jason Jang
LICENSING EVALUATOR NAME: Morgan Pringle
LICENSING EVALUATOR SIGNATURE:

DATE: 02/03/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/03/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3