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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 213001939
Report Date: 03/29/2023
Date Signed: 03/29/2023 10:03:03 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
02/02/2023 and conducted by Evaluator Hanson Leong
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230202122828
FACILITY NAME:C.A.M. (CFS) HAMILTON (PS)FACILITY NUMBER:
213001939
ADMINISTRATOR:LOMBARDI KELSEYFACILITY TYPE:
850
ADDRESS:5520 NAVE DRIVETELEPHONE:
(415) 883-3791
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY:80CENSUS: 14DATE:
03/29/2023
UNANNOUNCEDTIME BEGAN:
09:30 AM
MET WITH:Andreza BarriolaTIME COMPLETED:
10:02 AM
ALLEGATION(S):
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-Staff forced children to nap

-Staff handled children in a rough manner

-Staff spoke to children in an inappropriate manner
INVESTIGATION FINDINGS:
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On 3/29/2023, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced conclusionary complaint visit to the C.A.M Hamilton Preschool facility. The LPA was granted entry by Andreza Barriola. The LPA explained the purpose of the visit to Ms. Barriola. All the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed four staff members supervising fourteen preschool aged children. Children's capacity and ratio requirements were observed to be in compliance

All relevant information was gathered and analyzed during the LPA investigation, and all parties involved were contacted and interviewed. Based on information obtained from the LPA investigation, the LPA have found that the allegations, staff forced children to nap, staff handled children in a rough manner, and staff spoke to children in an inappropriate manner, may have happened or are valid, there is not a preponderance of evidence to prove the violation did or did not occur; therefore the above allegations are found to be unsubstantiated. ***See Page 2 for continuation***
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
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 2
Control Number 05-CC-20230202122828
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: C.A.M. (CFS) HAMILTON (PS)
FACILITY NUMBER: 213001939
VISIT DATE: 03/29/2023
NARRATIVE
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Continued, Page 2
A copy of this report and the “Notice of Site Visit” were given to Andreza Barriola

“The Notice of Site Visit” shall be posted for 30 days.

Failure to maintain postings as required, will result in an immediate $100 civil penalty.

Exit interview conducted and report was reviewed with Andreza Barriola

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 03/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/29/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2