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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 380505568
Report Date: 09/20/2023
Date Signed: 09/20/2023 12:31:20 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
09/14/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230914084316
FACILITY NAME:FAMILY DEVELOPMENTAL CENTER (PRESCHOOL)FACILITY NUMBER:
380505568
ADMINISTRATOR:QUIROZ, YOHANAFACILITY TYPE:
850
ADDRESS:2730 BRYANT STREETTELEPHONE:
(415) 282-1090
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:83CENSUS: DATE:
09/20/2023
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Dee LeeTIME COMPLETED:
12:40 PM
ALLEGATION(S):
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Facility has rodents.
Facility is unsanitary.
INVESTIGATION FINDINGS:
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On 9/20/2023 at 8:45AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Administrative Director, Dee Lee. Purpose of the inspection was explained and was for an Unannounced, 10-day complaint inspection. Present was the Administrative Director and 13 staff caring for 57 children. LPA inspected facility for health and safety hazards.

During inspection, LPA performed site observations, interviews and reviewed facility records.

During the course of this investigation, site observation was conducted on 9/20/2023. A review of the facility records was complete, which includes the sign-in sheets; staffing logs; and parent handbook. LPA conducted interviews with staff, administrative director and involved parties. (REFER TO LIC9099C, FOR CONT.)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
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 3
Control Number 05-CC-20230914084316
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: FAMILY DEVELOPMENTAL CENTER (PRESCHOOL)
FACILITY NUMBER: 380505568
VISIT DATE: 09/20/2023
NARRATIVE
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(Page 2)
Regarding the allegations of facility has rodents and is unsanitary; Based on interviews and observations; LPA determined allegations made are valid. During inspection, LPA observed rodent fences in the sunshine classroom. Therefore, the preponderance of evidence standard has been met, with allegations found to be SUBSTANTIATED. California code of Regulations (Title 22, Section 12 Chapter 1) are being cited on attached 9099D.

Notice of site visit was provided to the facility. Website for Forms and Regulations: www.ccld.ca.gov. Appeal rights were provided to director.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20230914084316
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: FAMILY DEVELOPMENTAL CENTER (PRESCHOOL)
FACILITY NUMBER: 380505568
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/20/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/25/2023
Section Cited
CCR
101238(a)
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101238(a) Buildings and Grounds The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. This requirement was not met as evidenced by:
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Facility will perform deep cleaning/ disinfecting of all preschool classrooms, including toys, accessible furniture, carpets, floors and surfaces by due date: 9/25/2023.
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During inspection, LPA observed rodent fences in the sunshine classroom. This poses a potential health and safety risk to children in care.
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Proof of correction will be submitted to the department via email.
Type B
09/20/2023
Section Cited
CCR
101238(a)(1)
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101238(a)(1) Buildings and Grounds. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents. This requirement was not met as evidenced by:
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 Facility will install additional preventive measures to properly address and mitigate the on-going rodent issue by the due date: 9/25/2023.
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During inspection, LPA observed rodent fences in the sunshine classroom. This poses a potential health and safety risk to children in care.
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Proof of correction will be submitted to he department via email.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/20/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/20/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3