380500308-1-5-2024-05-CC-GLEG-CZL3ET-20240117171141

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 380500308
Report Date: 01/04/2024
Date Signed: 01/05/2024 10:23:08 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO 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
10/27/2023 and conducted by Evaluator Cindy Mok

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20231027115815

FACILITY NAME:	HOLY FAMILY DAY HOME		FACILITY NUMBER:	380500308
ADMINISTRATOR:	POOYAN, SETAREH		FACILITY TYPE:	850
ADDRESS:	299 DOLORES STREET		TELEPHONE:	(415) 861-5361
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY:	150	CENSUS: 84	DATE:	01/04/2024
		UNANNOUNCED	TIME BEGAN:	09:05 AM
MET WITH:	Setareh Pooyah and Heather Morado		TIME COMPLETED:	10:40 AM

ALLEGATION(S):

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Staff handled a child improperly.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mok conducted an unannounced inspection to finalize this complaint with the Site Directors and explained the purpose of the inspection to her. There were 84 children with 25 staff present. Based on the interviews with witnesses & children conducted by LPA and Investigation Branch Investigator and the documents & unusual Incident report that were reported by the facility, there was no sufficient evidence to prove Staff handled a child improperly.

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.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/05/2024

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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