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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004763
Report Date: 12/06/2022
Date Signed: 12/06/2022 10:39:15 AM

Substantiated


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
11/18/2022 and conducted by Evaluator Cindy Mok
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20221118131009
FACILITY NAME:CRAYON COLLEGE, INC.FACILITY NUMBER:
414004763
ADMINISTRATOR:MICHELLE MANGINIFACILITY TYPE:
850
ADDRESS:401 SANTA LUCIA AVENUETELEPHONE:
(650) 588-4197
CITY:MILLBRAESTATE: CAZIP CODE:
94030
CAPACITY:48CENSUS: 11DATE:
12/06/2022
UNANNOUNCEDTIME BEGAN:
09:05 AM
MET WITH:Michelle ManginiTIME COMPLETED:
11:00 AM
ALLEGATION(S):
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A staff member was under the influence of alcohol while caring for daycare children.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mok conducted an unannounced inspection to finalize this complaint. LPA met with the Site Director, Michelle Mangili, and explained the purpose of the complaint inspection to her. There were 11 children with 2 staff present. Based upon the relevant information CCL gathered and staff interview, there was sufficient evidence to prove a staff was under the influence of alcohol while caring for daycare children without causing any unsafe issues to the children in care. The licensee sent the particular staff home within the same day she discovered the incident. The staff hasn't come to work since that day.

Based on the relevant documents CCL gathered, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
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 2
Control Number 05-CC-20221118131009
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: CRAYON COLLEGE, INC.
FACILITY NUMBER: 414004763
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/06/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/12/2022
Section Cited
CCR
101223(a)(2)
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101223(a)(2) Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights:
(2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.
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The licensee must set up a plan to prevent the same or similar incident happen in the facility and submit the plan to CCL by the due date (12/12/22).
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This requirement was not met as evidence-based upon the relevant information CCL gathered and staff interview, there was sufficient evidence to prove a staff was under the influence of alcohol while caring of daycare children without causing any unsafe issues to the children in care.

This poses a potential health 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.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 12/06/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2