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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 073408895
Report Date: 06/09/2023
Date Signed: 06/09/2023 03:42:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
BAY AREA-CC OAKLAND, 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
06/05/2023 and conducted by Evaluator Caroline Colson
PUBLIC
COMPLAINT CONTROL NUMBER: 02-CC-20230605155431

FACILITY NAME:AUTUMN CREEK LEARNING CENTERFACILITY NUMBER:
073408895
ADMINISTRATOR:BHARGAVA, ASMITA S.FACILITY TYPE:
850
ADDRESS:14 OSBORN WAYTELEPHONE:
(925) 743-4187
CITY:DANVILLESTATE: CAZIP CODE:
94526
CAPACITY:80CENSUS: 86DATE:
06/09/2023
UNANNOUNCEDTIME BEGAN:
09:48 AM
MET WITH:Asmita BhargavaTIME COMPLETED:
03:57 PM
ALLEGATION(S):
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Ratio - Classroom(s) operating out of capacity
INVESTIGATION FINDINGS:
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On Friday, June 9, 2023 at 9:48 AM, Licensing Program Analyst (LPA) Caroline Colson met with Asmita Bhargava, Center Director, for an unannounced complaint investigation. There are 86 preschool children and 20 staff members including the director. A health and safety tour was conducted. Licensee acknowledged that the empty school age classroom is being used for additional preschool children in the summer. Furthermore, Licensee explained that she didn't know that she had to make a formal request to the Department to use the school age classroom. Based on LPA's interviews which were conducted and a record review, the preponderance of evidence standard has been met, therefore the above allegation is found to be substantiated. California Code of Regulations, 101179 (a) is being cited on the attached LIC 9099 D.

The attached type B deficiency is being cited today and must be corrected by the due date. An exit interview was conducted. Appeal rights were given and discussed. A Site Notice was posted. This report must be available for public review for 3 years.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 02-CC-20230605155431
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: AUTUMN CREEK LEARNING CENTER
FACILITY NUMBER: 073408895
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2023
Section Cited
CCR
101179(a)
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Capacity Determination
A license shall be issued for a specific capacity, which shall be the maximum number of children that can be cared for at any given time. The Department may issue a license for fewer children than requested.
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Licensee will make a formal request to the Department to use the school age classroom in a flexible manner to obtain additional preschool children.
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This requirement was not met as evidenced by document review and licensee interview. This poses an potential health and safety risk to the children in care.
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Failure to correct will result in a $100.00 per day civil penalty until corrected. Repeat violations are 250.00 per violation and $100.00 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: Mayla Mendoza
LICENSING EVALUATOR NAME: Caroline Colson
LICENSING EVALUATOR SIGNATURE:

DATE: 06/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 5