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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 380504311
Report Date: 08/01/2019
Date Signed: 08/01/2019 03:04:04 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
07/30/2019 and conducted by Evaluator Cindy Mok
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20190730105150
FACILITY NAME:TRUE SUNSHINE PRESCHOOL CENTERFACILITY NUMBER:
380504311
ADMINISTRATOR:KONG, DIANAFACILITY TYPE:
850
ADDRESS:777 STOCKTON ST., RM. 201TELEPHONE:
(415) 956-4207
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94108
CAPACITY:44CENSUS: 36DATE:
08/01/2019
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Diana KongTIME COMPLETED:
03:30 PM
ALLEGATION(S):
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Child fell from the play structure and ended up with lower body injury
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mok conducted an unannounced inspection today. LPA met with the Site Director, Diana Kong. The purpose of the inspection was explained to her. There were 36 children with 8 staff present. During the investigation, LPA interviewed staff and obtained relevant information from the licensee. A teacher provided care and supervision at the climbing structure when the child fell from the structure, but the child resulted in lower-body injury.

Based on the interviews which were conducted and gathered information, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited in the attached LIC 9099D.

An exit inspection was conducted with Site Director and appeal rights were explained. A printed copy of the report, as well as a printed copy of the appeal rights, were provided to the Licensee at the conclusion of the inspection. Notice of site visit was posted and must remain posted for 30 days for public review.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
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-20190730105150
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: TRUE SUNSHINE PRESCHOOL CENTER
FACILITY NUMBER: 380504311
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/01/2019
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/02/2019
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights:
To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs. This requirement was not met as evidenced by based upon interviews.


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Licensee shall provide a Plan of Correction to ensure all facility staff have a training on the Child safety and injury prevention. Licensee shall provide a copy of the plan to Child Care Licensing by 8/2/2019. The POC shall include date of the training, and copy of the sign in/out when the training is completed.
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A teacher provided care and supervision at the climbing structure when the child fell from the structure, but the child resulted in lower-body injury.

This poses an immediate safety risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
LIC9099 (FAS) - (06/04)
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