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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 380504793
Report Date: 03/09/2022
Date Signed: 03/09/2022 02:50:22 PM

Unsubstantiated


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
01/03/2022 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20220103112700
FACILITY NAME:TELEGRAPH HILL NURSERY SCHOOLSFACILITY NUMBER:
380504793
ADMINISTRATOR:LUU, CONNIEFACILITY TYPE:
850
ADDRESS:660 LOMBARD STREETTELEPHONE:
(415) 421-6443
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94133
CAPACITY:87CENSUS: 60DATE:
03/09/2022
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Connie LuuTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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9
Staff denied restroom access to child in care.
INVESTIGATION FINDINGS:
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On 3/9/2022 at 9:15A.M., Licensing Program Analyst (LPA) Luis J. Gomez met with Lead Teacher Kim Du. Purpose of the inspection was explained and was for complaint investigation and to report findings. Program Director, Connie Luu arrived during inspection. Present was the program director and 12 staff supervising 60 children. All children present had been properly signed in. LPA inspected facility with director for health and safety hazards.

During inspection, LPA performed site observations, interviewed staff and reviewed facility records.

During the course of the investigation, site observations were conducted on 1/10/2022 and 3/9/2022. A review of the facility records was completed, which included the children’s files, staff files and program handbook. LPA conducted interviews with the director, staff, sample of parents, children and involved parties. Regarding allegation of staff denied restroom access to child in care; Based on interviews and evidence collected, LPA is unable to determine if staff denied restroom access to day-care child. (REFER TO LIC9099C, FOR CONT.)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
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-20220103112700
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: TELEGRAPH HILL NURSERY SCHOOLS
FACILITY NUMBER: 380504793
VISIT DATE: 03/09/2022
NARRATIVE
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(Page 2)

Although the allegations may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation(s) did or did not occur, therefore the allegation is Unsubstantiated.

LPA conducted exit interview with the Program Director. Appeal Rights were explained and the Notice of Site Visit was posted during inspection.

SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 03/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2