384002319-10-28-2021-05-CC-GLEG-C8TS4D-20211116123233

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384002319
Report Date: 10/28/2021
Date Signed: 10/28/2021 12:52:57 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
09/27/2021 and conducted by Evaluator April Cowan

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210927140512

FACILITY NAME:	HOLY FAMILY DAY HOME INFANT/TODLR CTR.		FACILITY NUMBER:	384002319
ADMINISTRATOR:	POOYAN, SETAREH		FACILITY TYPE:	830
ADDRESS:	299 DOLORES ST.,RMS #1 & #2		TELEPHONE:	(415) 861-5361
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY:	31	CENSUS: 92	DATE:	10/28/2021
		UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Setareh Pooyan		TIME COMPLETED:	01:10 PM

ALLEGATION(S):

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Facility refused to accept child after receiving negative COVID-19 test results.

Staff did not treat child with dignity

INVESTIGATION FINDINGS:

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On 10/28/21 at 12:30 PM, Licensing Program Analyst (LPA) Cowan met with site director, Setareh Pooyan, for an unannounced subsequent complaint inspection. The purpose of inspection was explained.

During the course of investigation, interviews were conducted with site director, staff, and parents. Through interviews, it has been found the facility did exclude a child from care as to abide by their exclusion policy which excludes any child who is showing signs of illness. LPA has not found any witness of mistreatment of any children.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is unsubstantiated.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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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