414001273-11-10-2020-05-CC-GLEG-BV9348-20201110165439

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414001273
Report Date: 11/10/2020
Date Signed: 11/10/2020 03:13:56 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
08/13/2020 and conducted by Evaluator Andrea Medlin

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20200813103522

FACILITY NAME:	BENAVIDES, MARIA A.		FACILITY NUMBER:	414001273
ADMINISTRATOR:	BENAVIDES, MARIA A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 745-8572
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	14	CENSUS: 2	DATE:	11/10/2020
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Maria Benavides		TIME COMPLETED:	03:45 PM

ALLEGATION(S):

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Licensee used inappropriate napping technique while daycare child was in care
Licensee left daycare child unattended while in care
Licensee failed to properly secure child during feedings

INVESTIGATION FINDINGS:

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Due to the current COVID-19 pandemic, a field visit is suspended at this time.

Licensing Program Analyst (LPA) Andrea Medlin completed this closing complaint investigation via tele-inspection. Interviews conducted with Licensee. LPA spoke to Licensee regarding nap time procedures, areas used for nap in the home; meal time incidents with children; staffing schedule during daycare hours. Licensee has children nap in the main daycare room using mats and cribs as age appropriate. Licensee denied any other areas in the home where a child may be put to nap other than the living room if needed for supervision. The garage has never been used. Licensee denies that daycare children are ever left alone during daycare hours; licensee and helper are there when needed. As for meal times, depending on the number of children, helper would feed the smaller children (infants), while the older children would sit at a small table and Licensee would bring the food. Licensee and helper do not recall any incidents of a child falling out of a high chair and getting injured.

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: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

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-20200813103522

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: BENAVIDES, MARIA A.	FACILITY NUMBER: 414001273
	VISIT DATE: 11/10/2020

NARRATIVE

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The investigation determined there is not enough available sufficient information provided in complaint to prove allegations of inappropriate napping procedures, child left unattended during care, or and incidents regarding a child not secured during meal/snack time resulting in an injury.

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. This report is provided to licensee through email.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/10/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/10/2020

LIC9099 (FAS) - (06/04)

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