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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005623
Report Date: 06/17/2024
Date Signed: 06/17/2024 11:42:38 AM

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
05/15/2024 and conducted by Evaluator Hanson Leong
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240515150008
FACILITY NAME:ACQUA TODDLER HOUSEFACILITY NUMBER:
214005623
ADMINISTRATOR:MENDOZA, NICOLASFACILITY TYPE:
830
ADDRESS:96 PILGRIM WAYTELEPHONE:
(415) 755-7075
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY:16CENSUS: 12DATE:
06/17/2024
UNANNOUNCEDTIME BEGAN:
10:13 AM
MET WITH:NIcolas MendozaTIME COMPLETED:
11:55 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff do not ensure that an infant's diapering needs are met
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 6/17/2024, Licensing Program Analysts (LPAs) Leong and Gil conducted an unannounced complaint visit to the Child Care Center (CCC) listed above. The purpose of the visit was to deliver the findings and to close out the complaint. LPAs met the Director, Nicolas Mendoza, and explained the purpose of the visit. Twelve children (six infants and six toddlers) and six staff members were present in the CCC. The six staff members present at the CCC received criminal record clearance from the department. The center is operating within its capacity and in accordance with the required ratio of staff to children.

During the LPA investigation, all relevant information was collected and analyzed, and all parties involved were contacted and interviewed. Based on the information obtained from the LPA investigation, the allegation listed above was unsubstantiated, meaning they may have happened or are valid. There is no preponderance of evidence to prove the violations did or did not occur.

A copy of this report was given to Nicolas Mendoza. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Nicolas Mendoza.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/17/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/17/2024
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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