414001893-10-20-2021-05-CC-GLEG-C8M3CQ-20211109170820

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414001893
Report Date: 10/20/2021
Date Signed: 10/20/2021 02:12:15 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
09/24/2021 and conducted by Evaluator April Cowan

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210924110348

FACILITY NAME:	KINDERCOURT PRESCHOOL		FACILITY NUMBER:	414001893
ADMINISTRATOR:	KIMBERLY MC GEE		FACILITY TYPE:	850
ADDRESS:	1601 LAUREL STREET		TELEPHONE:	(650) 592-7980
CITY:	SAN CARLOS	STATE: CA	ZIP CODE:	94070
CAPACITY:	28	CENSUS: 24	DATE:	10/20/2021
		UNANNOUNCED	TIME BEGAN:	01:30 PM
MET WITH:	Kim McGee		TIME COMPLETED:	02:30 PM

ALLEGATION(S):

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Child sustained unexplained injuries

INVESTIGATION FINDINGS:

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On 10/20/21 at 1:30 PM, Licensing Program Analyst (LPA) Cowan met with site director, Kimberly McGee, for an unannounced subsequent complaint inspection. The purpose of inspection was explained to licensee. Present in the facility is director and 4 staff caring for 24 children.
In today’s inspection, LPA along with licensee inspected for health and safety hazards. LPA observed no deficiencies during inspection.

During the course of investigation, interviews were conducted with site director, staff, child, and parents. It has been found that a child in care had unexplained marks on child’s arm upon pick up. The child has not been able to disclose what has happened to their arm, and it is unclear what has actually happened to the child. The child did not complain about any injury that day to staff, and staff state that they did not observe any injuries to the child. 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, therefore the allegation is UNSUBSTANTIATED.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April Cowan	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2021

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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