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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002757
Report Date: 09/27/2023
Date Signed: 09/27/2023 04:21:58 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
07/25/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230725141231
FACILITY NAME:SF TIKES ACADEMYFACILITY NUMBER:
384002757
ADMINISTRATOR:SHIMKUNAS, SARAHFACILITY TYPE:
850
ADDRESS:1218 SOUTH VAN NESS AVENUETELEPHONE:
(415) 826-8222
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:117CENSUS: 51DATE:
09/27/2023
UNANNOUNCEDTIME BEGAN:
01:30 PM
MET WITH:Kristina ItstovichTIME COMPLETED:
04:20 PM
ALLEGATION(S):
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Staff are not adequately supervising day care children in care.
INVESTIGATION FINDINGS:
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On 9/27/2023 at 1:30PM., Licensing Program Analyst (LPA) Luis J. Gomez met with Licensee, Kristina Itstovich. Purpose of the inspection was explained and was for an Unannounced, Complaint Investigation. Present was the Licensee and 8 staff supervising for 51 children. LPA inspected facility, indoor and outdoors, for health and safety hazards.

During today's inspection, LPA performed site observations, interviewed licensee, and reviewed facility records.

During the course of this investigation, observations were conducted 7/31/2023 and 9/27/2023. A review of the facility records was complete, which included the Staff Records; Children Records; and Parent Handbook. LPA conducted interviews Licensee, Director, Staff and Involved Parties. (REFER TO LIC9099C, FOR CONT.)
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 05-CC-20230725141231
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SF TIKES ACADEMY
FACILITY NUMBER: 384002757
VISIT DATE: 09/27/2023
NARRATIVE
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(Page 2)
Regarding allegation of staff are not adequately supervising day care children in care; Based on evidence collected, LPA was unable to determine if allegation made is valid. During inspections, LPA observed classrooms operating within the required Teacher- Child ratio.

Although the allegation may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is Unsubstantiated.



LPA conducted exit interview with Licensee, Kristina Itstovich. Complaint report explained, and the Notice of Site Visit was given during inspection.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2