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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384001285
Report Date: 01/17/2020
Date Signed: 01/17/2020 03:37:47 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
12/02/2019 and conducted by Evaluator Jennifer Yee
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20191202161110
FACILITY NAME:RAMIREZ, ELENAFACILITY NUMBER:
384001285
ADMINISTRATOR:RAMIREZ, ELENAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 859-5970
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 11DATE:
01/17/2020
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Elena RamirezTIME COMPLETED:
02:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Daycare provider hit daycare child.

Daycare child had an unexplained injury.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst, LPA Yee met with Licensee, Elena Ramirez to close this complaint. The purpose of the inspection was explained. There are 11 children in care. During the course of the investigation, LPA interviewed, licensee, staff members, witnesses, and obtained pictures.

Licensee denied both allegations that occurred at the daycare.

There have been conflicting statements made from all parties about the allegations, such that LPA is unable to determine whether or not the alleged allegation actually occurred. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 01/17/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/17/2020
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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