384001949-5-19-2021-05-CC-AZEA-C4ULSS-20210712090111

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384001949
Report Date: 05/19/2021
Date Signed: 05/19/2021 01:59:16 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
04/09/2021 and conducted by Evaluator Jennifer Yee

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210409101021

FACILITY NAME:	POTRERO KIDS AT DANIEL WEBSTER		FACILITY NUMBER:	384001949
ADMINISTRATOR:	KEE, REBECCA		FACILITY TYPE:	850
ADDRESS:	465 MISSOURI STREET		TELEPHONE:	(415) 550-3300
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94107
CAPACITY:	38	CENSUS: 0	DATE:	05/19/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Rebecca Kee		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Staff handles day care child in a inappropriate manner
Staff yells at day care child

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Yee conducted a telephone conference to close the complaint. During the course of the investigation, LPA interviewed 7 staff members and 3 parents.

As part of this investigation, LPA collected children's roster, teachers' working schedule, teacher's contact information, and parents' information. Based on the interviews that were conducted and the information collected during the investigation, LPA did not receive enough evidence to support the allegations above.

This agency has investigated the complaint although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED. This report must be available in the facility for public review.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer Yee	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/19/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/19/2021

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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