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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005422
Report Date: 11/20/2020
Date Signed: 11/20/2020 11:01:21 AM



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
09/01/2020 and conducted by Evaluator Farhan Bashir-Tariq
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20200901161504
FACILITY NAME:VASQUEZ, DAMARIS E.FACILITY NUMBER:
214005422
ADMINISTRATOR:VASQUEZ, DAMARIS E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 464-7473
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:14CENSUS: 4DATE:
11/20/2020
UNANNOUNCEDTIME BEGAN:
09:35 AM
MET WITH:Damaris VasquezTIME COMPLETED:
10:10 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee caused injuries to day-care children.
Licensee hit day-care children.
Licensee used an inappropriate form of discipline.
Licensee handled child in a rough manner.
Licensee called day-care children inappropriate names.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
**** This report was prepared in CCLD Regional Office, San Bruno on 11/20/20. This inspection was conducted via phone call due to COVID-19. Licensee was informed that a copy of today’s report will be emailed to her *****

Licensing Program Analysts (LPAs), Farhan Bashir-Tariq and Luis Gomez called and spoke to Licensee to deliver the findings of this complaint investigation on 11/20/20. Purpose of inspection was explained. During the course of this investigation, interviews were conducted with Parents, Staff, and Licensee. As part of this investigation, facility roster, and discipline policy were obtained from Licensee via email after initial visit of 9/15/20. After completing the investigation, there wasn’t enough evidence available to determine that allegations occurred in Licensee’s home.

This agency has investigated the complaint addressing all the allegations mentioned above. Based on the information obtained, although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED.


Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/20/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/20/2020
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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