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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384001117
Report Date: 11/14/2025
Date Signed: 11/14/2025 09:44:30 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
09/16/2025 and conducted by Evaluator Nicole Tran
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20250916163056
FACILITY NAME:CCFC-MARY LANE INFANT AND TODDLER CENTERFACILITY NUMBER:
384001117
ADMINISTRATOR:CRUZ, ERICKAFACILITY TYPE:
830
ADDRESS:ONE WEBSTER STREETTELEPHONE:
(628) 201-4295
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94117
CAPACITY:28CENSUS: 9DATE:
11/14/2025
UNANNOUNCEDTIME BEGAN:
08:46 AM
MET WITH:Site Supervisor, Rachele LongTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
-Staff did not provide adequate supervision, resulting in an infant sustaining an injury.
-Staff did not seek timely medical attention for infant.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On November 14, 2025 at approximately 8:45AM, Licensing Program Analyst (LPA) Tran conducted an unannounced, complaint visit to CCFC-Mary Lane Infant and Toddler Center. LPA met with Site Supervisor (S1), Rachele Long, and explained the purpose of the visit.

During today’s visit, LPA conducted a health and safety inspection. Present during the inspection was S1 and 9 staff supervising 9 infants.

Throughout the course of the investigation, LPA conducted classroom observations, gathered documents, and interviewed a random selection of staff. Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegations are UNSUBSTANTIATED at this time.

No deficiencies are being cited today. Appeal rights were provided and explained.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with facility representative, Rachele Long.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Nicole Tran
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025
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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