384002582-12-28-2023-05-CC-DJOO-CZ7RDY-20240105115641

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384002582
Report Date: 12/28/2023
Date Signed: 12/28/2023 09:57:35 AM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
10/25/2023 and conducted by Evaluator Sheran Lo

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20231025155030

FACILITY NAME:	KAI MING HEAD START - ST. LUKE CENTER (PS)		FACILITY NUMBER:	384002582
ADMINISTRATOR:	BANDELARIA, EVELYN		FACILITY TYPE:	850
ADDRESS:	1755 CLAY STREET		TELEPHONE:	(415) 690-1014
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94109
CAPACITY:	72	CENSUS: 18	DATE:	12/28/2023
		UNANNOUNCED	TIME BEGAN:	08:52 AM
MET WITH:	Venus Kong		TIME COMPLETED:	10:08 AM

ALLEGATION(S):

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Staff did not adequately supervise day care children, resulting in a child sustaining multiple injuries while in care.

INVESTIGATION FINDINGS:

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On December 28, 2023, Licensing Program Analyst (LPA), Sheran Lo conducted a subsequent complaint inspection and met with Family Advocate Venus Kong to discuss the above allegation. Purpose of the inspection was explained. Present is Family Advocate, 8 staff with 18 children.

During the course of the investigation, interviews were conducted with Director, parents, and relevant documents were gathered. Based on the interviews and relevant documents, there was no sufficient evidence to prove the staff did not adequately supervise children. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is Unsubstantiated.

LPA conducted exit interview with Family Advocate. Report and Notice of Site Visit was provided. Notice of Site Visit shall be posted for 30 consecutive days.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran Lo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/28/2023

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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