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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004134
Report Date: 04/03/2024
Date Signed: 04/03/2024 12:22:26 PM

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
03/29/2024 and conducted by Evaluator Cindy Mok
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240329090029
FACILITY NAME:AVENUES KINDERCARE, THEFACILITY NUMBER:
384004134
ADMINISTRATOR:HEMBERGER, EMILYFACILITY TYPE:
850
ADDRESS:334 28TH AVENUETELEPHONE:
(415) 221-6133
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:94CENSUS: 73DATE:
04/03/2024
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Karen TranTIME COMPLETED:
12:45 PM
ALLEGATION(S):
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Food for the children was not covered while transporting it from the kitchen to the classrooms.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mok conducted an unannounced inspection today. LPA met with the Assistant Site Director, Karen Tran, and explained the purpose of the visit during the inspection. There were 73 children with 11 staff present. Based on the LPA's observations and interviews with witnesses, it was found that the facility did not cover the food for the children inconsistently while transporting it from the kitchen to the classrooms.


Based on LPA's observations and interviews which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12 & Chapter 3), are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
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-20240329090029
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: AVENUES KINDERCARE, THE
FACILITY NUMBER: 384004134
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/03/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/17/2024
Section Cited
CCR
101227(8)
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101227 (8) Commercial foods shall be approved by appropriate federal, state and local authorities. All foods shall be selected, transported, stored, prepared and served so as to be free from contamination and spoilage and shall be fit for human consumption. Food in damaged containers shall not be accepted, used or retained.
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The Assistant Site Director modified the existing food service policy providing it to all staff members and requiring them to sign it. The Assistant Site Director also provided a copy of the updated policy with the staff signatures to LPA during the inspection. The deficiency was cleared during the inspection.
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This requirement was not met as evidence-based upon LPA's observations and interviews with witnesses, the facility did not cover the food for the children inconsistently while transporting it from the kitchen to the classrooms This poses a potential health risk to children in care.
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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: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2