414003061-2-28-2022-05-CC-DJOO-CCCVK5-20220309152944

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414003061
Report Date: 02/25/2022
Date Signed: 02/28/2022 05:43:44 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
01/10/2022 and conducted by Evaluator Andrea Medlin

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20220110133634

FACILITY NAME:	SORA INTNL PRESCHOOL OF SAN CARLOS		FACILITY NUMBER:	414003061
ADMINISTRATOR:	GARCIA, MAKO		FACILITY TYPE:	850
ADDRESS:	356 EL CAMINO REAL		TELEPHONE:	(650) 593-7672
CITY:	SAN CARLOS	STATE: CA	ZIP CODE:	94070
CAPACITY:	30	CENSUS: 20	DATE:	02/25/2022
		UNANNOUNCED	TIME BEGAN:	10:15 AM
MET WITH:	Hiroko Bilick		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

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Facility is not enforcing mask use at the facility.
Facility is not providing sufficient details to parents regarding positive COVID-19 cases.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Andrea Medlin conducted this conclusionay complaint visit. Purpose of visit explained. There are 20 children and 3 staff present during visit. Initiial complaint investigation conducted on 1/14/2021. Based on information obtained and observed, children wear masks at facility. The only times children do not wear masks is during nap time, eating during meal time, and playing outside. All staff wear masks while at facility. Director states she communicates with the families regarding any COVID-19 cases as discovered. More specific information is not provided such as personal details that are confidential, i.e. name of individual and additional identifying information. Facility does contact the local health department as incidents arise and follow their guidance regarding specific guidance related to the circumstances of the COVID case. Families are notified of information that is allowed to be shared in accordance with local health department guidance. 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 allegations are unsubstantiated.
This report is reviewed with facility representative and delivered via email and a copy of this report must be made available for public review upon request. Notice of Site visit posted and shall remain posted for 30 days.

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: 02/25/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2022

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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