<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410518832
Report Date: 10/10/2019
Date Signed: 10/10/2019 05:05:08 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:FRIENDS TO PARENTS, INC.FACILITY NUMBER:
410518832
ADMINISTRATOR:DIREKZE, MERLAFACILITY TYPE:
850
ADDRESS:2525 WEXFORDTELEPHONE:
(650) 588-8212
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:128CENSUS: 70DATE:
10/10/2019
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Juliette GalleroTIME COMPLETED:
01:55 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Andrea Medlin met with staff for this case management visit. The purpose of the visit is due to a self reported unusual incident. On 9/23/19, director had received an email with allegations against a particular staff person (S1). The allegations were in regard to some personal rights violation(s) against children in a particular classroom. Director had done an internal investigation, S1 was placed on leave, and ultimately terminated after another incident surfaced.

This is an isolated incident and appears the matter was handled appropriately. Unusual incident reporting requirements discussed with staff and reminded of more details being communicated with the licensing agency.

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

Notice of site visit posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 1