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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414000158
Report Date: 12/08/2023
Date Signed: 12/08/2023 11:15:20 AM

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
09/13/2023 and conducted by Evaluator Maria Olguin-Leon
COMPLAINT CONTROL NUMBER: 05-CC-20230913141624

FACILITY NAME:HAPPY CAMPERS PRESCHOOL DAYCAREFACILITY NUMBER:
414000158
ADMINISTRATOR:AUDRA TSIVIKASFACILITY TYPE:
850
ADDRESS:510 LAUREL STREETTELEPHONE:
(650) 678-8244
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY:106CENSUS: DATE:
12/08/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Audra TsivikasTIME COMPLETED:
11:45 AM
ALLEGATION(S):
1
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8
9
Staff are not ensuring parents sign day care children in and out
INVESTIGATION FINDINGS:
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2
3
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5
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12
13
On December 8, 2023 at approximately 9:15am, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced visit to deliver complaint findings for the above allegations. LPA met with the Director Audra Tsivikas and explained the purpose of the visit. Present during today’s visit were Director,14 staff and 58 children. Facility is operating within capacity.

During the course of the investigation, LPA conducted interviews, observations and reviewed pertinent documentation provided by parties involved. Based on evidence obtained, it was determined that the allegation of Staff is not ensuring parents sign day care children in and out, is determined to be UNSUBSTANTIATED. Although the above allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Audra Tsivikas. Appeal Rights were provided.

Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2023
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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