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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002976
Report Date: 09/24/2024
Date Signed: 09/24/2024 09:07:34 AM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO 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
07/25/2024 and conducted by Evaluator Winnie Ly
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240725183501
FACILITY NAME:XU, CHUNFACILITY NUMBER:
384002976
ADMINISTRATOR:XU, CHUNFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 297-2138
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY:14CENSUS: 7DATE:
09/24/2024
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Chun XuTIME COMPLETED:
08:45 AM
ALLEGATION(S):
1
2
3
4
5
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7
8
9
Licensee does not keep the home free from odor
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On September 24, 2024, at approximately 08:15am, Licensing Program Analyst (LPA) Ly, arrived at the family child care unannounced to close the complaint investigation to the above allegation and met with Licensee Xu Chun. Present during the visit were Licensee and an Assistant caring for 4 infant age children and 3 preschool age children. The facility operates within capacity limits and ratio during LPA’s visit.

Based on information gathered through interviews, records reviews and facility surveillance the agency has investigated the complaint allegation above, there was no sufficient evidence to allegation Licensee does not keep the home free from odor. Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur; therefore the allegation is UNSUBSTANTIATED.

This report has been discussed and verbally translated to Licensee in Cantonese. Licensee’s signature confirmed understood the report. This report and a notice of site visit were provided to licensee. Notice of Site Visit must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 09/24/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2024
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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