380500254-2-10-2023-05-CC-DJOO-CPA2SS-20230221163935

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 380500254
Report Date: 02/10/2023
Date Signed: 02/10/2023 10:55:11 AM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PENINSULA 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
11/10/2022 and conducted by Evaluator Nathan Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20221110170714

FACILITY NAME:	HAIGHT ASHBURY COOPERATIVE NURSERY SCHOOL		FACILITY NUMBER:	380500254
ADMINISTRATOR:	DRAKE, COCOA		FACILITY TYPE:	850
ADDRESS:	1180 STANYAN STREET		TELEPHONE:	(415) 661-9204
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94117
CAPACITY:	24	CENSUS: 2	DATE:	02/10/2023
		UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Cocoa Drake		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Lack of Supervision:
Staff did not provide adequate supervision resulting in child becoming lost.

INVESTIGATION FINDINGS:

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On 2/10/23, Licensing Program Analyst (LPA), Garcia made an unannounced visit to the Haight Ashbury Cooperative Nursery School facility to deliver the findings and close out a complaint in conjuction with annual inspection. LPA was granted entry by the director, Cocoa Drake. LPA explained the purpose of the visit to the licensee. All the facility's staff members have had their criminal background checks cleared by Guardian. Upon arrival, there were 2 preschool children and 3 parent volunteers working for the day.

During the LPA’s investigation, interviews, and record review which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
Please refer to 9099D for more information.
The Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain postings as required, will result in an immediate $100 civil penalty. This report is public and can be reviewed.

An exit interview was conducted with Licensee, Cocoa Drake. A copy of this report was reviewed and provided to licensee.

Substantiated

Estimated Days of Completion:

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2023

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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Control Number 05-CC-20221110170714

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HAIGHT ASHBURY COOPERATIVE NURSERY SCHOOL	FACILITY NUMBER: 380500254
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/10/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/13/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	101229 Responsibility for Providing Care and Supervision (a) the licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1).	1 2 3 4 5 6 7	Director shall develop measures that ensures that the children in care are supervised at all times.
	8 9 10 11 12 13 14	Supervision shall include visual observation. This requirement is not met as evidenced by: Based on investigation by LPA, the facility did not ensure supervision. This poses an immeditate health and safety risk to children in care.	8 9 10 11 12 13 14	Licensee will submit proof of written plan to LPA by due date.
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 02/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/10/2023

LIC9099 (FAS) - (06/04)

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