<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073407423
Report Date: 11/09/2022
Date Signed: 11/09/2022 11:30:08 AM

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
09/15/2022 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20220915153914
FACILITY NAME:BABY YALE ACADEMYFACILITY NUMBER:
073407423
ADMINISTRATOR:MUAZZAMA(AFRIN) QURASHYFACILITY TYPE:
850
ADDRESS:5521 LONE TREE WAY STE100TELEPHONE:
(925) 308-7693
CITY:BRENTWOODSTATE: CAZIP CODE:
94513
CAPACITY:74CENSUS: 14DATE:
11/09/2022
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lita ReevesTIME COMPLETED:
11:40 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Child sustained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Cherie Acosta and Christina Watts conducted an unannounced visit to investigate the above allegation. LPAs met with Licensee Lita Reeves. Director was not available during the inspection as she was in ratio. There were 14 children and 4 staff present during the inspection.

During the investigation LPA conducted interviews and reviewed incident reports.
It was determined that a child in care has bitten other children on separate occasions.
Based on interviews which were conducted and record reviews, the preponderance of evidence standard has been met, therefore the above allegation is substantiated.
The attached type A violation is cited today and must be corrected by the due date. Upon receipt, licensee shall post 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. All parents/guardians must sign an acknowledgement form of proof of receiving this report (LIC9224). The LIC 9224 must be placed in the child's file to be reviewed by licensing.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
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-20220915153914
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: BABY YALE ACADEMY
FACILITY NUMBER: 073407423
VISIT DATE: 11/09/2022
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
The facility was cited for a violation of the same regulation, 101229(a) Responsibility for Providing Care and Supervision, on 6/16/22. A civil penalty of $250.00 is assessed today for a repeat violation within a 12-month period.

Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Licensee Lita Reeves.
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 02-CC-20220915153914
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: BABY YALE ACADEMY
FACILITY NUMBER: 073407423
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/09/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type A
11/10/2022
Section Cited
CCR
101229(a)
1
2
3
4
5
6
7
Responsibility for Providing Care and Supervision. The licensee shall provide care and supervision as necessary to meet the children's needs. This requirement was not met as evidenced by:
1
2
3
4
5
6
7
Licensee shall ensure staff are trained on supervision. Facility shall submit training agenda to CCL by 11/10/22. Facility shall provide proof of completed training. All staff shall write a statement about what they learned in the training and submit to CCL by 11/23/22
8
9
10
11
12
13
14
a child in care has bitten other children which poses an immediate risk to the health and safety of children in care
8
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.
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 11/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/09/2022
LIC9099 (FAS) - (06/04)
Page: 3 of 3