414003086-12-4-2019-05-CC-GLEG-BK5SBB-20191223124337

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414003086
Report Date: 12/04/2019
Date Signed: 12/04/2019 10:16:02 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
10/24/2019 and conducted by Evaluator Brendon Van

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20191024161044

FACILITY NAME:	TRAN, ANDY N.		FACILITY NUMBER:	414003086
ADMINISTRATOR:	TRAN, ANDY N.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 281-1556
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94062
CAPACITY:	14	CENSUS: 10	DATE:	12/04/2019
		UNANNOUNCED	TIME BEGAN:	07:30 AM
MET WITH:	Andy Tran		TIME COMPLETED:	09:30 AM

ALLEGATION(S):

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-Uncleared adults living at home

INVESTIGATION FINDINGS:

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Licensing Program Analysts (LPAs) Van and Bashir-Tariq conducted an unannounced subsequent complaint investigation and met with Licensee, Andy Tran. LPAs explained the purpose of the inspection and was granted entry to the facility by the licensee. Present, there are two helpers, the licensee and 10 children ( 2 infants and 8 preschoolers). The facility is operating within teachers/children ratio.

LPAs and licensee inspected the inside and out of the facility for health and safety hazards. As part of this complaint investigation, complainant, licensee, helper, and random parents were interviewed; records and relevant information were reviewed. Based on the available information, there was no evidence observed to support the above allegation. Records reviewed confirmed that all staff or other individuals who live at home or require caregiver background checks had received criminal record clearance.

This agency has investigated the complaint alleging uncleared criminal record adults who are living in the home. Based on the information obtained, 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 allegations are UNSUBSTANTIATED.

An exit interview was conducted with the licensee. This report and rights to comment were discussed with the licensee. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit.

Unsubstantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/04/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2019

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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