384001263-4-26-2024-05-CC-GLEG-D4W2LB-20240502172914

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384001263
Report Date: 04/26/2024
Date Signed: 04/26/2024 09:12:00 AM

Unsubstantiated

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
02/15/2024 and conducted by Evaluator Man Tso

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20240215162419

FACILITY NAME:	JCCSF HELEN DILLER FAMILY PRESCHOOL		FACILITY NUMBER:	384001263
ADMINISTRATOR:	CIANCI, KARLA		FACILITY TYPE:	850
ADDRESS:	3200 CALIFORNIA STREET		TELEPHONE:	(415) 292-1291
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94118
CAPACITY:	175	CENSUS: 19	DATE:	04/26/2024
		UNANNOUNCED	TIME BEGAN:	08:27 AM
MET WITH:	Karyn Khan		TIME COMPLETED:	09:25 AM

ALLEGATION(S):

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Lack of supervision resulting in daycare being kicked on multiple occasions by another daycare child.
Staff did not provide a safe environment for daycare child.

INVESTIGATION FINDINGS:

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On April 26, 2024, at approximately 8.30AM, Licensing Program Analyst (LPA) Tso conducted an unannounced visit for delivery of the complaint investigation findings and met with the Assistant Director, Karyn Khan. LPA explained the purpose of the visit and was granted entry to the facility by the Assistant Director. Present, the Assistant Director, 10 staff are supervising 19 children.

During the course of the investigation, interviews were conducted with children and staff members and relevant documents were gathered. Based on the interviews, observation, and information obtained there was no sufficient evidence to prove that the allegations listed above, occurred. Although the allegations may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegations are UNSUBSTANTIATED.

Exit interview conducted and this report was reviewed with the Assistant Director whose signature confirm have read the report. Report must be made available for public review upon request. A copy of this report and appeal rights have been discussed and left with the Assistant Director. Notice of Site Visit shall remain posted for 30 days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 04/26/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2024

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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