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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073407410
Report Date: 09/03/2024
Date Signed: 09/03/2024 03:28:06 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
08/29/2024 and conducted by Evaluator Ashley Curry
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240829132644
FACILITY NAME:KLA SCHOOLS OF WALNUT CREEKFACILITY NUMBER:
073407410
ADMINISTRATOR:ELIF KALKANFACILITY TYPE:
850
ADDRESS:298 N. WIGET LANETELEPHONE:
(925) 357-8080
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:170CENSUS: 124DATE:
09/03/2024
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Elif KalkanTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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Facility staff left children outside unattended
INVESTIGATION FINDINGS:
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On 09/03/2024 at 11:15 AM Licensing Program Analyts (LPAs) A. Curry and M. Caro conducted an unannounced complaint visit. LPA met with the Director, Elif Kalkan, to discuss the above allegation. LPAs toured the facility, retrieved documentation, and conducted interviews with staff. Multiple interviews revealed a child was left unsupervised and found crying alone in the middle play ground. Interviews also revealed this was not the first time a child was left unsupervised. Therefore the above allegation is found to be SUBSTANTIATED. Violations of the California Code of Regulations, Title 22, Division 12, 101229(a)(1) is being cited on the attached LIC 9099D.



***Report continued on LIC 9099C***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
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
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 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
08/29/2024 and conducted by Evaluator Ashley Curry
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20240829132644

FACILITY NAME:KLA SCHOOLS OF WALNUT CREEKFACILITY NUMBER:
073407410
ADMINISTRATOR:ELIF KALKANFACILITY TYPE:
850
ADDRESS:298 N. WIGET LANETELEPHONE:
(925) 357-8080
CITY:WALNUT CREEKSTATE: CAZIP CODE:
94598
CAPACITY:143CENSUS: 124DATE:
09/03/2024
UNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Elif KalkanTIME COMPLETED:
03:45 PM
ALLEGATION(S):
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9
Facility staff did not properly report an unusual incident
INVESTIGATION FINDINGS:
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On 09/03/2024 at 11:15 AM Licensing Program Analyts (LPAs) A. Curry and M. Caro conducted an unannounced complaint visit. LPA met with the Director, Elif Kalkan, to discuss the above allegation. LPAs toured the facility, retrieved documentaion, reviewed facility records, and conducted interviews with staff. Multiple interviews revealed a child was left unsupervised and the director was aware that a child was left unsupervised. Although the Director indicated the parent was notified, the facility did not notify Licensing of the incident. Therefore the above allegation is found to be SUBSTANTIATED. Violations of the California Code of Regulations, Title 22, Division 12, Section 101212(d)(1)(C) is being cited on the attached LIC 9099D.

Notice of site visit was given and must remain posted for 30 days.

Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Elif Kalkan.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 02-CC-20240829132644
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KLA SCHOOLS OF WALNUT CREEK
FACILITY NUMBER: 073407410
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/17/2024
Section Cited
CCR
101212(d)(1)(C)
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101212Reporting Requirements(d)Upon the occurrence..of any.. events..(d)(1)..a report shall be made to the Department by telephone or fax within the Dept's next working day..a written report.. shall be submitted to the Department within seven days..(1) Events reported..(C)Any unusual incident or child absence..
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By 09/17/2024 email LPA a written plan on how the facility will comply with the Reporting Requirements regulations.
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This requirement is not met as evidence by:
Based on interviews and record review the facility did not comply with the section cited above by not ensuring the facility is reporting all unusual incidents to Licensing within the required time frame.
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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: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 02-CC-20240829132644
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612
FACILITY NAME: KLA SCHOOLS OF WALNUT CREEK
FACILITY NUMBER: 073407410
VISIT DATE: 09/03/2024
NARRATIVE
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LPA A. Curry informed Director, Elif Kalkan that this report dated 09/03/2024 document(s) 1 Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPA A. Curry informed the Director to provide a copy of this licensing report dated 09/03/2024 that documents any Type A citation(s) 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.


Notice of site visit was given and must remain posted for 30 days.


Exit interview conducted, appeal rights were given, and report was reviewed with the Director, Elif Kalkan.
SUPERVISORS NAME: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 02-CC-20240829132644
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND CC RO, 1515 CLAY STREET, SUITE 1102
OAKLAND, CA 94612

FACILITY NAME: KLA SCHOOLS OF WALNUT CREEK
FACILITY NUMBER: 073407410
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/04/2024
Section Cited
CCR
101229(a)(1)
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101229Responsibility 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...
This requirement is not met as evidence by:
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By 09/04/2024 email LPA a written plan on how the facility will ensure no child is left outside unsupervised.
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Based on interviews the facility did not comply with the section cited above by not ensuring no child is left without supervision at any time.
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By 10/02/2024 conduct an all staff training on supervision. Email LPA the agenda for the training and sign in sheet for all staff who attended the training.
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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: Monica Mathur
LICENSING EVALUATOR NAME: Ashley Curry
LICENSING EVALUATOR SIGNATURE:

DATE: 09/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/03/2024
LIC9099 (FAS) - (06/04)
Page: 5 of 5