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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414002295
Report Date: 12/08/2020
Date Signed: 12/24/2020 11:37:50 AM



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
10/08/2020 and conducted by Evaluator Cindy Interiano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20201008065553
FACILITY NAME:DE OCAMPO, ANAFACILITY NUMBER:
414002295
ADMINISTRATOR:DE OCAMPO, ANAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 566-1254
CITY:MENLO PARKSTATE: ZIP CODE:
94025
CAPACITY:12CENSUS: DATE:
12/08/2020
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Licensee, Ana De OcampoTIME COMPLETED:
01:30 PM
ALLEGATION(S):
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9
Licensee is taking daycare children to an unlicensed facility
INVESTIGATION FINDINGS:
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***Amended report***
Licensing Program Analyst (LPA), Cindy Interiano, conducted a subsequent complaint investigation via phone call and spoke to Licensee, Ana De Ocampo. Licensee is currently caring for 4 Preschool children.
Licensee states her Mother lives in the property next door. Licensee has listed her Mother’s house as a relocation site in case of an emergency. Licensee does not take daycare children to Mother’s house, unless it is an emergency, and no children are being cared for at her Mother’s house. There was a recent incident in which Licensee felt it necessary to take the children to the emergency relocation site for a brief time, but later returned to her licensed facility.
Although the allegation of Licensee taking daycare children to an unlicensed facility may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is found to be 'Unsubstantiated.'
An exit interview was conducted. Appeal rights were explained to the Licensee.
Report will be emailed to Licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/08/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/08/2020
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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