<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384003092
Report Date: 04/14/2026
Date Signed: 04/14/2026 01:23:24 PM

Substantiated


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
04/08/2026 and conducted by Evaluator Man Tso
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260408143341
FACILITY NAME:CHAPMAN, NICOLEFACILITY NUMBER:
384003092
ADMINISTRATOR:CHAPMAN, NICOLE D.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 508-9763
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:14CENSUS: DATE:
04/14/2026
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Nicole ChapmanTIME COMPLETED:
01:35 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff or Licensee handled the child roughly
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 14, 2026, at approximately 11.30AM, Licensing Program Analyst (LPA) Tso conducted an unannounced complaint investigation visit and met with the licensee, Nicole Chapman. LPA explained the purpose of the inspection and were granted entry to the facility by the licensee. Present, the licensee and mother/helper are supervising 3 children (1 infant and 2 preschool aged).

Based on LPA’s gathered information through observation, interview and records reviews, the agency has investigated the complaint allegation above. The facility did not comply with the children’s personal rights regulations. The preponderance of evidence standard has been met. The above allegation is found to be SUBSTANTIATED. A Type A violation was issued today, April 14, 2026 in accordance with the California Code of Regulations, Title 22, Division 12, citation was being cited on the attached LIC 9099D.

(Continued on Page 2, .....)


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
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 3
Control Number 05-CC-20260408143341
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHAPMAN, NICOLE
FACILITY NUMBER: 384003092
VISIT DATE: 04/14/2026
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
(Continued, page 2, ...)

This report has been discussed and reviewed with licensee whose signature confirmed have read the report. The Facility is advised to provide a copy of the Complaint Investigation Report and the Type "A" Deficiency cited to the parents and guardians of children currently enrolled in care and parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files. This report will be maintained in the facility file and made available for public review three years after the thirty-day posting requirement has been met.

Exit interview conducted and a copy of this report and appeal rights were discussed and left with the licensee, Nicole Chapman, whose signature on this form confirms receipt of these reports. Notice of Site Visit was provided and to be remained posted for 30 days.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20260408143341
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHAPMAN, NICOLE
FACILITY NUMBER: 384003092
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/14/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/15/2026
Section Cited
CCR
102423(a)(4)
1
2
3
4
5
6
7
102423 Personal Rights (a) Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative… (4) To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The licensee must provide the Licensing Department with the policy on how to handle the children in care upholding their personal rights on or before April 15, 2026.

8
9
10
11
12
13
14
Based on observation, interview and records review, the Licensee did not comply with the section cited above that the Licensee / helper handled the child roughly, which pose an immediate health, safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
1
2
3
4
5
6
7
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 04/14/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/14/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 3