384001093-2-2-2023-05-CC-GLEG-CPKTJQ-20230303134640

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384001093
Report Date: 02/02/2023
Date Signed: 02/02/2023 12:26:26 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PENINSULA 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
01/03/2023 and conducted by Evaluator Cindy Mok

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20230103151033

FACILITY NAME:	EPIPHANY PARENT-CHILD CENTER		FACILITY NUMBER:	384001093
ADMINISTRATOR:	LYNETTE JONES		FACILITY TYPE:	830
ADDRESS:	100 MASONIC AVENUE		TELEPHONE:	(415) 567-8370
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94118
CAPACITY:	39	CENSUS: 0	DATE:	02/02/2023
		ANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Lynette Jones		TIME COMPLETED:	12:50 PM

ALLEGATION(S):

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Day care child got an injury while in care

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Mok conducted an inspection to finalize this complaint. LPA met with the Site Director, Lynette Jones, and explained the purpose of the complaint inspection to her. It had no children present because the facility was closed to move all equipment & furniture to another building that will be licensed for the program. Based on the interviews conducted and documents gathered by CCL, there was no sufficient evidence to prove a daycare child got a scratch under the child's eye at the facility,

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

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

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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