<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005515
Report Date: 06/15/2023
Date Signed: 06/15/2023 02:16:59 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
04/11/2023 and conducted by Evaluator Leslit Tapia-Mandujano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230411084743
FACILITY NAME:CATZIM DIAZ, REINA G.FACILITY NUMBER:
214005515
ADMINISTRATOR:CATZIM DIAZ, REINA G.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 524-9434
CITY:NOVATOSTATE: CAZIP CODE:
94947
CAPACITY:14CENSUS: 14DATE:
06/15/2023
UNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Licensee, Reina G. Catzim DiazTIME COMPLETED:
02:40 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Licensee restricted day care child's movement.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On June 15th, 2023 at approximately 10am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, complaint investigation and met with licensee, Reina G. Catzim Diaz regarding the above allegation and explained the purpose of the visit. LPA toured the home for health and safety hazards. During today's inspection, LPA also interviewed assitant, licensee, and obtained copies of the updated children's roster.

Complaint was received by the Department on 04/11/23. Present in the facility are licensee, assistant, and licensee's teenage daughter caring for 14 children (2 infants, 11 preschoolers, and 1 school age). All adults working or living in the facility have fingerprint clearance and are associated.

During the course of the investigation, interviews were conducted with licensee, parents, assistants, involved parties, and relevant documents were gathered. Based on interviews and observations, it was determined that the restriction of children's movement has occured by not strictly following the manufacture directions on how furnishing and eqipments are intended to be used resulting in children's movement to be limited.

Continued on Page 2...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
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 3
Control Number 05-CC-20230411084743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CATZIM DIAZ, REINA G.
FACILITY NUMBER: 214005515
VISIT DATE: 06/15/2023
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
Page 2 Continued...

Based on interviews, and observations which were conducted, 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 1, are being cited. Please refer to LIC 9099D for more information.

After today’s visit, an exit interview was conducted with licensee, Reina G. Catzim Diaz. A copy of this report was reviewed and provided to licensee.

Upon receipt of this report, Licensee shall post the Notice of Site Visit. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain postings as required, will result in an immediate $100 civil penalty. This report is public and can be reviewed.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20230411084743
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CATZIM DIAZ, REINA G.
FACILITY NUMBER: 214005515
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/16/2023
Section Cited
CCR
102423(a)(2)
1
2
3
4
5
6
7
102423: Personal Rights:(a):Each child receiving services from a family child care home shall have certain rights that shall not be waived...These rights include, but are not limited to, the following: (2) To receive safe, healthful, and comfortable accommodations, furnishings, and equipment.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
LPA explained the regulation to licensee and made Licensee aware that all furnsihing/eqipment should be used following manufacture directions. LPA advised that she look up directions for all objects used.

Licensee will also ensure that assistant is made aware and is following the same directions.
8
9
10
11
12
13
14
Based on observation and interview, the licensee did not comply with the section cited above as furnishings/equipment were not used following manufactured direction which caused the limited restriction of children in care, which poses a potential health, safety or personal rights risk to children in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3