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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 015700222
Report Date: 09/21/2023
Date Signed: 09/21/2023 02:47:18 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/18/2023 and conducted by Evaluator Jyoti Saini
PUBLIC
COMPLAINT CONTROL NUMBER: 52-CC-20230818103858
FACILITY NAME:SINGH, TVAPRAKASHFACILITY NUMBER:
015700222
ADMINISTRATOR:SINGH, TVAPRAKASHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(510) 706-7570
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:14CENSUS: 9DATE:
09/21/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee, Tvaprakash Singh TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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The provider does not properly wash daycare children's bottles, resulting in mold.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation and met licensee Tvaprakash Singh. Present there were licensee and helper supervising nine (9) children (four infants and four preschoolers and one schoolage).
Based on interviews and observation, LPA did not observe mold in the children's water bottles. Furthermore, the licensee mentioned that the water bottles are washed/sanitized in the dishwasher daily. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is unsubstantiated.

An exit interview was conducted with Licensee, Tvaprakash Singh.

A notice of site visit was posted and must remain posted for a period of 30 days.


Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
This is an official report of an unannounced visit/investigation of a complaint received in our office on
08/18/2023 and conducted by Evaluator Jyoti Saini
COMPLAINT CONTROL NUMBER: 52-CC-20230818103858

FACILITY NAME:SINGH, TVAPRAKASHFACILITY NUMBER:
015700222
ADMINISTRATOR:SINGH, TVAPRAKASHFACILITY TYPE:
810
ADDRESS:8112 MULBERRY PLACETELEPHONE:
(510) 706-7570
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY:14CENSUS: 9DATE:
09/21/2023
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee, Tvaprakash Singh TIME COMPLETED:
03:00 PM
ALLEGATION(S):
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9
Provider does not ensure that the outside play area is free of clutter.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Jyoti Saini arrived unannounced to deliver the findings from a complaint investigation for the above allegation and met licensee Tvaprakash Singh. Present there were licensee and helper supervising nine (9) children (four infants and four preschoolers and one schoolage)
Based on interviews, observation, and record review, LPA concluded that the backyard, which is an on-limit area of the home, was used to store bikes, toys, and stacked miscellaneous items on top of each other, occupying most of the space not allowing for ease of movement to children in care. The daycare area must remain free of hazards all the time. The preponderance of evidence standard has been met; therefore, the allegation is found to be SUBSTANTIATED.California Code of Regulations, {Title 22, Division & Chapter Number 102417(b) } is being cited on the attached LIC 9099D.
LICENSEE MUST POST ANY TYPE A DEFICIENCIES DURING TODAYS VISIT WITH THE NOTICE AND LICENSEE UNDERSTANDS THE NOTICE AND TYPE A DEFICIENCIES MUST REMAIN POSTED FOR THIRTY DAYS. REQUIREMENTS FOR AB 633 FACT SHEET AND A COPY OF ACKNOWLEDGEMENT OF RECEIPT OF LICENSING REPORTS (LIC 9224) WERE DISCUSSED WITH PROVIDER. PROVIDER UNDERSTANDS THIS REQUIREMENT.
see next page...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
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 4
Control Number 52-CC-20230818103858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME: SINGH, TVAPRAKASH
FACILITY NUMBER: 015700222
VISIT DATE: 09/21/2023
NARRATIVE
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An exit interview was conducted with Licensee, Tvaprakash Singh.

A notice of site visit was given and must remain posted for a period of 30 days.

The Facility's appeal rights were reviewed and given to the Licensee, Tvaprakash Singh.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 52-CC-20230818103858
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
OAKLAND SOUTH EAST, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: SINGH, TVAPRAKASH
FACILITY NUMBER: 015700222
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/22/2023
Section Cited
CCR
102417(b)
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102417(b) Operation of a Family Child Care Home:The home shall be kept clean and orderly, with heating and ventilation for safety and comfort.
This requirement is not met, as evidence by:
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The Licensee has cleaned and organized the backyard already. The Licensee shall ensure that the facility is always clean and orderly.
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Based on the interviews and observations, the facility failed to keep the daycare area clean and orderly. LPA observed that the facility's backyard had toys, bikes, and miscellaneous items stacked up, which poses an immediate health and safety risk to children in the 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: Wynn Norona
LICENSING EVALUATOR NAME: Jyoti Saini
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2023
LIC9099 (FAS) - (06/04)
Page: 4 of 4