380504984-1-13-2021-05-CC-GLEG-BX94PR-20210113181711

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 380504984
Report Date: 01/13/2021
Date Signed: 01/13/2021 04:16:33 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
10/16/2020 and conducted by Evaluator Luis Gomez

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20201016164806

FACILITY NAME:	KATHERINE MICHIELS SCHOOL		FACILITY NUMBER:	380504984
ADMINISTRATOR:	ZELLERBACH, LAURA ROSE		FACILITY TYPE:	830
ADDRESS:	1335 GUERRERO STREET		TELEPHONE:	(415) 821-1434
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	15	CENSUS:	DATE:	01/13/2021
		UNANNOUNCED	TIME BEGAN:	04:15 PM
MET WITH:	Director, Yolanda Ancheta		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Facility staff is not qualified
Facility is over ratio

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

THE FOLLOWING INSPECTION WAS CONDUCTED VIA TELE-INSPECTION DUE TO THE COVID-19 HEALTH EMERGENCY

On 1/13/2021 at 4:15P.M., Licensing Program Analyst (LPA) Luis J. Gomez contacted director, Yolanda Ancheta via phone call to report the complaint investigation findings of the above allegation(s). Complaint was received by the CCL on October 16, 2020. LPA left a voice message for the director. A copy of this report will be sent via mail and email to the facility.

As part of this investigation, LPA reviewed the facility records which include the Staff Files, Children/ Parent’s Rosters, Personnel Roster and relevant documents. As part of this complaint investigation, interviews were conducted the facility personnel, sample of parents and the involved parties.

(Continuation on 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/12/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/12/2021

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-20201016164806

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: KATHERINE MICHIELS SCHOOL	FACILITY NUMBER: 380504984
	VISIT DATE: 01/13/2021

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

(Page 2)
Regarding the allegation of facility staff is not qualified. Based on staff interviews and record review, LPA determined day-care staff is qualified. During facility record review, LPA observed site director and two teachers are fully qualified with required post secondary units.

Regarding the allegation of facility is over ratio. Based on staff interviews and facility record review, LPA determined facility is operating at the required teacher - child ratio. During interviews conducted with infant/ toddler personnel, it was reported that staff follow proper ratio requirements at all times.

Although the allegation(s) may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is Unsubstantiated. Copy of this report will be mailed to the licensee. No deficiencies are cited.

Copy of this report was provided to site director, Yolanda Ancheta, and director was advised if she had any questions to call the Community Care Licensing Office, 650-266-8800 from 8am- 5pm Website: www.ccld.ca.gov

Signed copy of this report will be stored in facility file.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/13/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/13/2021

LIC9099 (FAS) - (06/04)

Page: 2 of 2