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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414001492
Report Date: 07/20/2023
Date Signed: 07/20/2023 01:50:41 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
05/24/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230524154320
FACILITY NAME:SHORES CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414001492
ADMINISTRATOR:BECKER, LISAFACILITY TYPE:
850
ADDRESS:1050 TWIN DOLPHIN DRIVETELEPHONE:
(650) 594-1100
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY:158CENSUS: 87DATE:
07/20/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Lisa Becker TIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff pushed daycare child.
INVESTIGATION FINDINGS:
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On 7/20/2023 at 9:00AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Director, Lisa Becker. Purpose of inspection was explained and was for an unannounced; complaint investigation. Present was the Director and 15 staff, 87 children. LPA inspected facility, indoors and outdoors, for health and safety hazards.

During today's inspection, LPA performed site observations, interviews, and reviewed facility records. At 11:00AM., Based on record review, LPA confirmed staff’s proof of required immunization were missing from facility files. Advisory Note: Technical Violation (LIC9102TV) was issued.

During the course of this investigation, site observations were conducted on, 5/30/2023 and 7/20/2023. A review of the facility records was complete, which included the Parent Handbook; Personnel Records; and Children's Roster. LPA conducted interviews with the Director, Staff, Children, and Involved Parties. (REFER TO LIC9099C, FOR CONT.)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 2
Control Number 05-CC-20230524154320
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SHORES CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414001492
VISIT DATE: 07/20/2023
NARRATIVE
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(Page 2)
Based on evidence collected, LPA is unable to determine if staff pushed day-care child. During interviews, staff reported using appropriate intervention strategies when assisting day-care children.

Although the 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 the allegation is Unsubstantiated.

LPA conducted exit interview and reviewed complaint report with Director, Lisa Becker. Notice of Site Visit provided and shall remain posted for 30 consecutive days.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/20/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/20/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2