213006109-10-4-2022-05-CC-DJOO-CKUUZ6-20221104160059

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 213006109
Report Date: 10/04/2022
Date Signed: 10/04/2022 02:24:30 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
07/21/2022 and conducted by Evaluator Jennifer Yee

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20220721145217

FACILITY NAME:	C.A.M. (CFS) MARIN HEAD START LYNWOOD (PS)		FACILITY NUMBER:	213006109
ADMINISTRATOR:	LOMBARDI, KELSEY		FACILITY TYPE:	850
ADDRESS:	1320 LYNWOOD DRIVE		TELEPHONE:	(415) 883-3791
CITY:	NOVATO	STATE: CA	ZIP CODE:	94949
CAPACITY:	40	CENSUS: 14	DATE:	10/04/2022
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	MARGARITA VENCES		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Staff do not treat daycare child with respect

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA), Yee conducted an unannounced inspection to deliver the findings of this complaint investigation. The purpose of the inspection was explained. There are 14 napping children and two staff members present today. During the course of investigation, interviews were conducted with Director, three Staff members, six parents, two witnesses and Reporting Party. As part of this investigation, a roster was obtained.

This agency has investigated the complaint alleging staff do not treat daycare child with respect. Based on the information obtained, although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. No citations were issued on this report. This report must be available in the facility for public review. Facility was advised to call office for anthy additional questions, M - F, 8 AM-5 PM at 650-266-8800. Website: www.cdss.ca.gov

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/04/2022

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/04/2022

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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