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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414001493
Report Date: 05/26/2020
Date Signed: 05/28/2020 04:30:16 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
03/13/2020 and conducted by Evaluator April Cowan
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20200313111321
FACILITY NAME:SHORES CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414001493
ADMINISTRATOR:ROBINSON, ONEIKIFACILITY TYPE:
830
ADDRESS:1050 TWIN DOLPHIN DRIVETELEPHONE:
(650) 594-1100
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY:112CENSUS: 0DATE:
05/26/2020
ANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Arlene GarciaTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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Classroom operates out of ratio

Bathrooms have no paper towels
INVESTIGATION FINDINGS:
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On May 26, 2020 at 2:00 PM Licensing Program Analyst (LPA) Cowan met with District Leader Arlene Garcia for a subsequent complaint inspection. Due to Covid-19, Shelter in place, the inspection was conducted via Facetime. School school is currently closed and does not expect to open before June 15, 2020 and school staff are not available. LPA discussed the nature of the complaint with district leader as well as findings.

During the course of investigation, LPA interviewed staff and parents. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2020
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 3
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
03/13/2020 and conducted by Evaluator April Cowan
COMPLAINT CONTROL NUMBER: 05-CC-20200313111321

FACILITY NAME:SHORES CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414001493
ADMINISTRATOR:ROBINSON, ONEIKIFACILITY TYPE:
830
ADDRESS:1050 TWIN DOLPHIN DRIVETELEPHONE:
(650) 594-1100
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY:112CENSUS: 0DATE:
05/26/2020
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Arlene GarciaTIME COMPLETED:
04:00 PM
ALLEGATION(S):
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9
Facility failed to keep facility bathroom clean
INVESTIGATION FINDINGS:
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On May 26, 2020 at 2:00 PM Licensing Program Analyst (LPA) Cowan met with District Leader Arlene Garcia for a subsequent complaint inspection. Due to Covid-19, Shelter in place, the inspection was conducted via Facetime. School is currently closed and does not expect to open before June 15, 2020. Therefore, school's staff are not available. LPA discussed the nature of the complaint with district leader as well as the findings.

During the investigation, LPA inspected the bathrooms with the site director. LPA observed that the perimeters bathroom floors of all second floor bathrooms were lined with layers of dust. Site director agreed that the bathroom floors were not clean. Based on LPA’s observation the preponderance of evidence standard has been met, therefore the above allegation is founded to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20200313111321
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: SHORES CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414001493
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/26/2020
Section Cited
CCR
101238.3(b)
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101238.3 Indoor Activity Space
(b) The floors of all rooms shall have a surface that is safe and clean. This requirement was not met as evidenced by:
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District Leader agrees to oversee a meeting with staff regarding training on facility's cleaning process as well as send correspondence to the janitorial service. Director agrees to send a copy of training notes and letter to LPA by June 26, 2020.
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Base on LPA's observations facility did not make sure that bathroom floors were cleaned. This poses a potential risk to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2020
LIC9099 (FAS) - (06/04)
Page: 3 of 3