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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408864
Report Date: 05/02/2025
Date Signed: 05/02/2025 02:42:37 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
03/25/2025 and conducted by Evaluator Cherie Acosta
COMPLAINT CONTROL NUMBER: 02-CC-20250325160852
FACILITY NAME:KIDDIE ACADEMYFACILITY NUMBER:
073408864
ADMINISTRATOR:NOELLE MILLSFACILITY TYPE:
850
ADDRESS:1620 NEROLY RD.TELEPHONE:
(925) 261-6717
CITY:OAKLEYSTATE: CAZIP CODE:
94561
CAPACITY:114CENSUS: 54DATE:
05/02/2025
UNANNOUNCEDTIME BEGAN:
12:30 PM
MET WITH:Abadat (Abi) KhanTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Staff inappropriately handled child in care.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Cherie Acosta and Jamel Maiwandi conducted an unannounced visit regarding the above allegation. LPAs met with Director Abadat (Abi) Khan.
During the investigation LPAs conducted interviews and reviewed video footage.
The video footage shows S1 holding C1's arm as C1 was attempting to pull his arm away.
Based on LPAs observation and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is to be substantiated.
Notice of Site Visit was provided and must be posted for 30 days.
Exit interview and report reviewed with Abadat (Abi) Khan.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
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 2
Control Number 02-CC-20250325160852
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: KIDDIE ACADEMY
FACILITY NUMBER: 073408864
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/16/2025
Section Cited
CCR
101223(a)(3)
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Personal Rights.The licensee shall ensure that each child is accorded the following personal rights: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 including but not limited to:
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Director shall have individual trainings with all staff on personal rights. Director shall submit proof of these training to CCL by 5/16/25. Director will provided additional training on personal rights during an all staff meeting on 6/6/25.
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interference with functions of daily living including eating, sleeping or toileting; or withholding of shelter, clothing, medication or aids to physical functioning.This requirement was not met as evidenced by S1 handled C1 inappropriatly which is a potential risk to the health and safety of children in care.
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• 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.
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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: Sherelle Johnson
LICENSING EVALUATOR NAME: Cherie Acosta
LICENSING EVALUATOR SIGNATURE:

DATE: 05/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2025
LIC9099 (FAS) - (06/04)
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