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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 380504567
Report Date: 03/08/2023
Date Signed: 06/14/2023 04:25:52 PM

Substantiated


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
03/06/2023 and conducted by Evaluator Sheran Lo
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230306101010
FACILITY NAME:SFUSD-DR. CHARLES DREW (EES) PRESCHOOLFACILITY NUMBER:
380504567
ADMINISTRATOR:FRANKLIN, VIDRALEFACILITY TYPE:
850
ADDRESS:50 POMONA ST.TELEPHONE:
(415) 379-2700
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:72CENSUS: 33DATE:
03/08/2023
UNANNOUNCEDTIME BEGAN:
12:03 PM
MET WITH:Alisa Chriss-PriceTIME COMPLETED:
01:34 PM
ALLEGATION(S):
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Staff left child unsupervised in classroom
INVESTIGATION FINDINGS:
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On March 8, 2023, Licensing Program Analyst (LPA), Sheran Lo conducted a complaint inspection and met with Adminstrative Assistant Alisa Chriss-Price, to discuss the above allegation. Purpose of the inspection was explained. Present is Admin, 6 teachers with 33 children.

The preponderance of evidence standard has been met, therefore the allegation of a lack of supervision resulting in staff leaving child unsupervised in classroom is found to be SUBSTANTIATED.

***See attached page for deficiencies cited against the facility under CCR,Title 22, Div. 12, Ch. 1.***
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Sheran Lo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 05-CC-20230306101010
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: SFUSD-DR. CHARLES DREW (EES) PRESCHOOL
FACILITY NUMBER: 380504567
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/08/2023
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision (a) The licensee shall provide care and supervision as necessary...(1) No child(ren)... left without the supervision of a teacher at any time.. Supervision...include visual observation.
This requirement is not met as evidenced by:
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Facility has done training the next day after incident for staff and put in more protocols in place to implement supervision during transitions.
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Based on interviews, facility did not ensure to provide supervision at all times, which poses a potential Health, Safety, and Personal Rights risk to persons in care.
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Plan of correction was completed on 2/17/2023.
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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: Daniel J Oquendo
LICENSING EVALUATOR NAME: Sheran Lo
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
LIC9099 (FAS) - (06/04)
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