380500308-8-13-2020-05-CC-GLEG-BT4RQY-20200903131419

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 380500308
Report Date: 08/13/2020
Date Signed: 08/13/2020 12:34:15 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
08/03/2020 and conducted by Evaluator April Cowan

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20200803094945

FACILITY NAME:	HOLY FAMILY DAY HOME		FACILITY NUMBER:	380500308
ADMINISTRATOR:	MEYERS-THUM, KIM		FACILITY TYPE:	850
ADDRESS:	299 DOLORES STREET		TELEPHONE:	(415) 861-5361
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY:	150	CENSUS:	DATE:	08/13/2020
		UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Setareh Pooyan and Heather Morado		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Children are exposed to cleaning compounds while in care.

INVESTIGATION FINDINGS:

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On 8/13/20 at 11:30 Licensing Program Analyst (LPA) Cowan met with Site Director and Executive Director for an announced subsequent complaint inspection. Due to Covid-19 Shelter in Place, the inspection was conducted via Facetime. The purpose of inspection was explained to directors.
In today’s inspection, LPA interviewed directors and further discussed the nature of the complaint. According to directors, cleaning is never done while children are present.

During the course of investigation, LPA has reviewed all submitted documents. 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.

This report is emailed to the director with a request for a reply to confirm receipt.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/13/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/13/2020

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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