410518531-7-27-2021-05-CC-GLEG-C5C234-20210727170142

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 410518531
Report Date: 07/23/2021
Date Signed: 07/27/2021 04:29:18 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
04/26/2021 and conducted by Evaluator Andrea Medlin

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210426083823

FACILITY NAME:	NAVARRETE, GLORIA L.		FACILITY NUMBER:	410518531
ADMINISTRATOR:	NAVARRETE, GLORIA L.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 873-6956
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	12	CENSUS:	DATE:	07/23/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Gloria Navarrete		TIME COMPLETED:	03:30 PM

ALLEGATION(S):

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PERSONAL RIGHTS: Lack of supervision resulting in day care child engaging in inappropriate behavior.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Andrea Medlin completed a conclusionary complaint investigation. Initial investigation was conducted on 5/4/2021; at that time, interview with Licensee was conducted. More information was requested and later obtained by LPA including children's roster, children's schedules, and misc documentation. LPA conducted interviews with relevant parties and gathered information regarding allegation. According to Licensee, a child (C1) attended the daycare on various days and had little to no interaction with one enrolled daycare children and it is unknown how much interaction C2 may have had specifically with C1. C2 only attended the daycare for the purpose of remote distance learning, since due to COVID-19, all school related functions were conducted remotely. Licensee states C2 was separate from the rest of daycare children while doing "online/video" school instruction in a private separate bedroom. According to Licensee, C2 brought and used a school issued electronic device to use for "school." Licensee is not aware of any other electronic devices C2 may or may not have had in his possesion. It was alleged that a child (C2) showed/displayed inappropriate images/videos to another younger child (C1), however there is not enough information available to prove if any other electronic device was available or if any inappropriate images were shown to any children while at the facility.
(Continued on next page 9099-C)

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

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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Control Number 05-CC-20210426083823

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: NAVARRETE, GLORIA L.	FACILITY NUMBER: 410518531
	VISIT DATE: 07/23/2021

NARRATIVE

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The investigation determined there is not enough available information at this time to prove if there were any violations of a child's personal rights.

Although these allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore these allegations are closed as unsubstantiated.

This report is reviewed with Licensee and a copy of this report must be made available for public review upon request.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2021

LIC9099 (FAS) - (06/04)

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