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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414000987
Report Date: 10/03/2019
Date Signed: 10/03/2019 12:24:17 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
08/02/2019 and conducted by Evaluator Glenn A Schnell
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20190802120833
FACILITY NAME:IHSD, INC-MOONRIDGE INFANT CENTERFACILITY NUMBER:
414000987
ADMINISTRATOR:INES MORALESFACILITY TYPE:
830
ADDRESS:2001 MIRAMONTES POINT ROADTELEPHONE:
(650) 712-9687
CITY:HALF MOON BAYSTATE: CAZIP CODE:
94019
CAPACITY:9CENSUS: 7DATE:
10/03/2019
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Ines Morales/Barbara DonnellyTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
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9
Infant sustained unexplained injuries while in care
INVESTIGATION FINDINGS:
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5
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9
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13
Licensing Program Analysts (LPA's) Glenn Schnell and Kassandra Medrano conducted a complaint investigation inspection today for the purpose of delivering findings for the above allegation. As part of this investigation, staff and parents were interviewed and children and staff as well as facility records were reviewed. LPA's also conducted an evaluation of care and supervision of the children and reviewed facility policies and procedures for doing wellness checks on the infant children during pick up and drop off times, as well as throughout the day. Site Supervisor Morales explained wellness checks allow for staff to identify and report any questionable or unexplained marks or injuries to children. The above allegation stems from an observation of insect bite marks and a bruise on the right ear of an infant child that attends the program. Based on interviews conducted and internal facility documentation reviewed, There was no explantion of the insect bites. LPA's learned that the injuries either occured while the child was in care, riding and falling off of a bike, or away from the facility not in care by facility staff. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur while the child was in care, therefore the allegation is unsubstantiated.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/03/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019
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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