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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004090
Report Date: 07/26/2023
Date Signed: 07/26/2023 10:03:39 AM

Substantiated


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
05/04/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230504084431
FACILITY NAME:LAMA, NADIA V.FACILITY NUMBER:
384004090
ADMINISTRATOR:LAMA, NADIA V.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 286-4319
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:14CENSUS: 0DATE:
07/26/2023
UNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Nadia Lama TIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Licensee argued with parent in presence of daycare child.
INVESTIGATION FINDINGS:
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On 7/26/2023 at 9:15AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Licensee, Nadia Lama. Purpose of the inspection was explained and was for an unannounced, complaint investigation. Per licensee, day-care is closed for the summer break. Present was licensee and no children. LPA inspected facility for health and safety hazards.

During inspection, LPA performed site observations, interviews, and reviewed facility records. At 10:00AM, Based on record review and interview, LPA confirmed licensee missing required records from enrolled children. Advisory Note: Technical Violation (LIC9102TV) was issued.

During the course of the investigation, observations were conducted on . A review of the facility records was complete, which included the children’s files, and children’s roster (LIC9040). LPA conducted interviews with staff, licensee and involved parties. (REFER TO LIC9099C, FOR CONT.)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
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 5
Control Number 05-CC-20230504084431
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: LAMA, NADIA V.
FACILITY NUMBER: 384004090
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/31/2023
Section Cited
CCR
102423(1)
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102423 Personal Rights: 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. These rights include, but are not limited to, the following:(1) To be treated with dignity in his/her personal relationship with staff and other persons. This requirement was not met as evidenced by:
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Licensee will review children's personal rights resource videos on department website by due date: 7/31/2023.
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Based on evidence collected, LPA confirmed licensee argued with parent in presence of day-care child. This poses a potential health and safety risk to children in care.
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Licensee will submit proof of correction via email.
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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: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 5
Control Number 05-CC-20230504084431
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: LAMA, NADIA V.
FACILITY NUMBER: 384004090
VISIT DATE: 07/26/2023
NARRATIVE
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(Page 2)
Regarding the allegation of licensee argued with parent in presence of day-care child; Based on evidence collected, LPA determined allegation made is valid.

Based on information obtained, the preponderance of evidence standard has been met, therefore the allegation is found to be SUBSTANTIATED. California code of Regulations (Title 22, Section 12 Chapter 1) are being cited on attached 9099D. Appeal Rights were provided to licensee.

Notice of site visit was provided and must remain posted for 30 days.

This report will be kept in the facility file and will be made available for Public Review upon request. Website for Forms and Regulations: www.ccld.ca.gov.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/26/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 5