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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384000052
Report Date: 07/23/2019
Date Signed: 07/23/2019 04:10:54 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
06/28/2019 and conducted by Evaluator Gagandeep Singh
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20190628144555
FACILITY NAME:WILLIAMS, ARNELLAFACILITY NUMBER:
384000052
ADMINISTRATOR:WILLIAMS, ARNELLAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 822-0509
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:12CENSUS: 7DATE:
07/23/2019
UNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Arnella Williams & Artiese WilliamsTIME COMPLETED:
04:30 PM
ALLEGATION(S):
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9
Licensee denied day care child's authorized representative access to the home.
Licensee failed to adequately supervise day care child(ren).
Licensee failed to ensure home was in good repair while operating.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Singh met with licensee, Arnella Williams, and her daughter, Artiese Williams, to investigate the above allegations. Purpose of the inspection was explained. During the inspection, LPA inspected the facility and interviewed the licensee and her daughter. During the record review, LPA observed the list of authorized representatives of the child and found that the alleging person is not included in the list. During interviews, it was found that licensee let the child’s representative talk to the child and kept the supervision. During today’s inspection, LPA observed licensee and two other helpers supervising the children. During the interviews, it was found that licensee had repairs in the house, but during the construction time, areas with construction material was blocked and was made inaccessible for the children.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is unsubstantiated. Copy of this report is reviewed and provided to the licensee. Notice of site visit is posted and shall remain posted for next 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep SinghTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2019
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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