384001621-5-20-2021-05-CC-AZEA-C48SV8-20210622141217

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384001621
Report Date: 05/19/2021
Date Signed: 05/20/2021 03:05:59 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
04/07/2021 and conducted by Evaluator Cindy Mok

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210407103134

FACILITY NAME:	COW HOLLOW SCHOOL		FACILITY NUMBER:	384001621
ADMINISTRATOR:	DARCY CAMPBELL		FACILITY TYPE:	850
ADDRESS:	65 FUNSTON AVE		TELEPHONE:	(415) 921-2328
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94129
CAPACITY:	60	CENSUS: 20	DATE:	05/19/2021
		UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Darcy Campbell		TIME COMPLETED:	03:00 PM

ALLEGATION(S):

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Amended:

Lack of supervision resulting in inappropriate interactions between children

INVESTIGATION FINDINGS:

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Licensing Program Analyst, Mok, finalized this complaint via the phone with the Site Director, Darcy Campbell, due to CDSS suspended the field inspections temporarily during the COVID19 pandemic. Child Care Licensing delivered this report to the licensee via e-mail. LPA conducted interviews and gathered relevant documents during the investigation.

During the investigation, LPA conducted interviews with Director, staff, and other relevant parties and reviewed pertinent documents regarding the above allegation. Based on witness statements, the facility had appropriate staff for each classroom, and teachers were attentive and engaged with the children. Children were always within the eyesight of staff whether inside the classrooms or outside in the play yard.

Although the allegation of lack of supervision resulting in children having inappropriate interactions may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore the allegation is found to be UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/20/2021

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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