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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002350
Report Date: 10/20/2022
Date Signed: 10/20/2022 10:38:15 AM

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
08/29/2022 and conducted by Evaluator Catrina Quimbo
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20220829093024
FACILITY NAME:UCSF KIRKHAM CDC (PS)FACILITY NUMBER:
384002350
ADMINISTRATOR:NANCY TRINH COSTANTIELLOFACILITY TYPE:
850
ADDRESS:10 KIRKHAM STREETTELEPHONE:
(415) 664-1217
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94143
CAPACITY:93CENSUS: 43DATE:
10/20/2022
UNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Natasha Lau & Kulsimranjit KaurTIME COMPLETED:
10:35 AM
ALLEGATION(S):
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Day care child's parent is not allowed to enter and inspect the facility.
INVESTIGATION FINDINGS:
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On October 20, 2022 at approximately 8:35am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, complaint visit to UCSF Kirkham. LPA met with instructional coach, Kulsimranjit Kaur, and interim health and safety director, Natasha Lau, and explained the purpose of the visit.

Present at facility are 12 staff members (including intructional coach and interim health and safety director) and 43 enrolled children. Facility is licensed to operate out of 6 classrooms. Program is currently operating out of 4 of the 6 classrooms: Stingray, Otter, Sea Turtle and Starfish. Classrooms not currently in use: Seahorse and Jellyfish.

As part of this investigation, LPA conducted classroom observations, reviewed facility's policy documents, interviewed staff and random selection of enrolled children's parents. Document provided to LPA discussed updated facility's pick up and drop off procedures as of 08/29/2022, allowing children's authorized representatives to enter and be present in the classroom.
(Continue on 9099-C)
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
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-20220829093024
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: UCSF KIRKHAM CDC (PS)
FACILITY NUMBER: 384002350
VISIT DATE: 10/20/2022
NARRATIVE
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(Continued, Page 2)
Selection of staff interviewed stated parents are allowed to enter the classroom. Staff also stated parents were present in classroom prior to updated facility's pick up and drop off procedures implementation.

Random selection of children's parent interviewed stated they were present in the classroom prior to updated facility's pick up and drop off procedures implementation.

Although the above allegation may have happened or is valid, based on LPA's interview and observations and record review which was conducted, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with instructional coach, Kulsimranjit Kaur, and interim health and safety director, Natasha Lau.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 10/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022
LIC9099 (FAS) - (06/04)
Page: 2 of 2