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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408426
Report Date: 02/08/2023
Date Signed: 02/08/2023 03:38:49 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
11/17/2022 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20221117140710
FACILITY NAME:TAGHOUTI, JUNEFACILITY NUMBER:
073408426
ADMINISTRATOR:TAGHOUTI, JUNEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 313-4603
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY:14CENSUS: 9DATE:
02/08/2023
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:TAGHOUTI, JUNE TIME COMPLETED:
03:45 PM
ALLEGATION(S):
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9
Personal Rights ~ Provider uses fear to intimidate children in care.
INVESTIGATION FINDINGS:
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2
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5
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12
13
On February 8, 2023 Licensing Program Analyst (LPA) Nyeesha Blount conducted an unannounced complaint investigation inspection. LPA met with licensee Taghouti, June. Present during the visit were (2) staff members, (9) preschool children. A health and safety inspection was conducted.

During the investigation LPA conducted interviews and reviewed documents. Based on staff interviews conducted Reporting party that was a prior staff member used a scary halloween mask to scare a child to go to sleep. The preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.
Substantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
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 4
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
11/17/2022 and conducted by Evaluator Nyeesha Blount
COMPLAINT CONTROL NUMBER: 02-CC-20221117140710

FACILITY NAME:TAGHOUTI, JUNEFACILITY NUMBER:
073408426
ADMINISTRATOR:TAGHOUTI, JUNEFACILITY TYPE:
810
ADDRESS:181 FALCON WAYTELEPHONE:
(510) 313-4603
CITY:HERCULESSTATE: CAZIP CODE:
94547
CAPACITY:14CENSUS: 9DATE:
02/08/2023
UNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:TAGHOUTI, JUNETIME COMPLETED:
03:45 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Personal Rights ~ Child is physically restrained.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On February 8, 2023 Licensing Program Analyst (LPA) Nyeesha Blount conducted an unannounced complaint investigation inspection. LPA met with licensee Taghouti, June. Present during the visit were (2) staff members, (9) preschool children. A health and safety inspection was conducted.

During the investigation LPA conducted interviews and reviewed documents. Based on staff interviews conducted Licensee stated she held a child's hand slightly force to help with behavioral issues. The preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.
Substantiated
Estimated Days of Completion: 60
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4
Control Number 02-CC-20221117140710
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: TAGHOUTI, JUNE
FACILITY NUMBER: 073408426
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/08/2023
Section Cited
CCR
101223(a)(3)
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101223 Personal Rights (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, coercion, threat, mental abuse or other actions of a punitive nature. This requirement is not met as evidenced by:
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Licensee will send a written plan of correction of how children will be treated according to the personal rights section in the Title 22 regulation. Also watch personal rights video on CCLD website. Licensee will have parents complete LIC 9224 form and place in children's file. By POC due date of February 22, 2023
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Based on interviews, Staff member used a scary Halloween mask to scare a child to go to sleep. This is an immediate risk to Health and Safety or Personal Rights risk to persons in care.
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14
Type B
02/08/2023
Section Cited
CCR
101223(a)(3)
1
2
3
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5
6
7
101223 Personal Rights (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, coercion, threat, mental abuse or other actions of a punitive nature. This requirement is not met as evidenced by:
1
2
3
4
5
6
7
Licensee will have a staff meeting to discuss personal rights and submit written statement to LPA via email. By POC due date of February 22, 2023.


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Based on interviews, Licensee stated she held a child hands with slight force to help control behavior issues. This is an immediate risk to Health and Safety or Personal Rights risk to persons 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.
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Nyeesha Blount
LICENSING EVALUATOR SIGNATURE:

DATE: 02/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/08/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 4