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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384000322
Report Date: 10/14/2021
Date Signed: 10/14/2021 12:14:00 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
08/17/2021 and conducted by Evaluator Winnie Ly
COMPLAINT CONTROL NUMBER: 05-CC-20210817123542
FACILITY NAME:LITTLE ANGELS JAPANESE PRESCHOOLFACILITY NUMBER:
384000322
ADMINISTRATOR:HIRAI, HISAMIFACILITY TYPE:
850
ADDRESS:1457 NINTH AVENUETELEPHONE:
(415) 564-6123
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY:30CENSUS: 3DATE:
10/14/2021
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Hisami HiraiTIME COMPLETED:
12:30 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff exhibiting unsafe conduct around children in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On October 14, 2021, at approximately 11:30AM, Licensing Program Analyst (LPA) Winnie Ly conducted an unannounced visit at 2545 Judah Street, San Francisco, 94122 to close the complaint that was filed for the address 1457 9th Avenue, San Francisco, 94122. LPA met with Director Hisami Hirai and purpose of visit was explained. Present during the visit were the Director and the Director’s husband as an assistant caring for 3 children.

Based on observations and interviews which were conducted, there was no sufficient evidence to prove staff exhibiting unsafe conduct around children in care. Although the allegation 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 UNSUBTANTIATED.

A copy of this report and appeal rights were discussed and left with facility director whose signature on this form confirms receipt of documents. A notice of site visit was provided to the Director and shall remain posted for 30 days.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 10/14/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/14/2021
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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