214005476-3-5-2020-05-CC-AZEA-BN3U72-20200326151914

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 214005476
Report Date: 03/05/2020
Date Signed: 03/05/2020 03:41:02 PM

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
01/10/2020 and conducted by Evaluator Farhan Bashir-Tariq

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20200110105640

FACILITY NAME:	LIMA, BRUNA R.		FACILITY NUMBER:	214005476
ADMINISTRATOR:	LIMA, BRUNA R.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 747-1921
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	12	CENSUS: 8	DATE:	03/05/2020
		UNANNOUNCED	TIME BEGAN:	02:55 PM
MET WITH:	Bruna Lima		TIME COMPLETED:	04:00 PM

ALLEGATION(S):

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Facility is operating out of ratio.

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Farhan Bashir-Tariq and Luiz Gomez arrived at the facility unannounced and met with licensee, Bruna Lima to deliver the findings of this complaint investigation. Purpose of the inspection was explained. Present there were 8 children in care ( 4 infants and 4 Pre-k) with Licensee and Helper, Selina Reyesdeleon. Facility is operating within licensed capacity and ratio limits as of today 3/5/20. This is a subsequent visit and LPA, Farhan Bashir-Tariq collected a copy of children’s roster and information about field trips previously on 1/16/20. LPA observed that licensee was following the ratio and capacity requirements on 1/16/20

As part of the investigation today, LPAs toured the facility including off limit areas to verify the capacity and ratio limits and observed that licensee was complying to the required limits. Based on the information obtained during visits, licensee interview, and records review, LPAs did not receive enough evidence to support the allegation. This agency has investigated the complaint alleging that licensee is operating out of ratio. 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 violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/05/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/05/2020

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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