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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005617
Report Date: 07/08/2025
Date Signed: 07/08/2025 12:45:38 PM

Unsubstantiated


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
05/01/2025 and conducted by Evaluator Nathan Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20250501133506
FACILITY NAME:GROVE PRESCHOOL AT KOL SHOFAR, THEFACILITY NUMBER:
214005617
ADMINISTRATOR:BARBONI, KATHERINEFACILITY TYPE:
850
ADDRESS:215 BLACKFIELD DRIVETELEPHONE:
(415) 388-1818
CITY:TIBURONSTATE: CAZIP CODE:
94920
CAPACITY:105CENSUS: 50DATE:
07/08/2025
UNANNOUNCEDTIME BEGAN:
10:09 AM
MET WITH:Katherine Barboni/Liza MongeTIME COMPLETED:
01:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff engages in inappropriate behavior in the presence of day care children
Staff does not provide adequate supervision to day care children
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 8, 2025, Licensing Program Analyst (LPA) Garcia conducted an unannounced complaint investigation visit at the facility. LPA met with facility director, Katherine Barboni and explained the purpose of the visit. Present during the visit were 50 children in care with 13 teachers.

During the course of the investigation, pertinent documents were reviewed and interviews were conducted with staff. Based on the interviews and relevant documents, there's no sufficient evidence to prove that "Staff engages in inappropriate behavior in the presence of day care children" and "Staff does not provide adequate supervision to day care children".

Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is Unsubstantiated.

Report and Notice of Site Visit was provided.
Notice of Site Visit shall be posted for 30 consecutive days.

Exit interview conducted and report was reviewed with the director, Katherine Barboni.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 07/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/08/2025
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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