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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004189
Report Date: 02/01/2024
Date Signed: 02/01/2024 05:20:44 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
01/31/2024 and conducted by Evaluator Man Tso
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240131145536
FACILITY NAME:APPLE TREE CHILDREN CENTER-INFANTFACILITY NUMBER:
384004189
ADMINISTRATOR:LIN, SHUYINGFACILITY TYPE:
830
ADDRESS:1331 HARRISON STREETTELEPHONE:
(415) 695-4726
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY:16CENSUS: 8DATE:
02/01/2024
UNANNOUNCEDTIME BEGAN:
03:11 PM
MET WITH:Shuying, LinTIME COMPLETED:
05:30 PM
ALLEGATION(S):
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Overcapacity
INVESTIGATION FINDINGS:
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On February 01, 2024 at 2:20 PM, Licensing Program Analysts (LPAs), Tso and Van made an unannounced 10-day complaint inspection and met with Director, Shuying Lin. Purpose of the inspection was explained. Present in the facility is the Director, 4 teachers, and 8 children. Children’s Roster and Sign in/out records were obtained. During the inspection, observation, interviews, and records review were conducted with the Director.

Based on LPAs’ gathered information through observation, interviews and records reviews, the agency has investigated the complaint allegation above, overcapacity. Per the Director, she admitted that the facility operated overcapacity. The Director also stated that the agencies, Wu Yee and Children Council (“Agencies”) called her yesterday (1/31/24) to inform the children referred by the agencies were no longer to attend the facility anymore. Per the Director, there were 20 infants (a list of children’s names) with the last day in care on January 31, 2024.

The facility failed to comply with the Limitations on Capacity regulations. The preponderance of evidence standard has been met. The above allegation is found to be SUBSTANTIATED. A Type A violation was issued today, February 01, 2024 in accordance with the California Code of Regulations, Title 22, Division 12 & Chapter 1, citation is being cited on the attached LIC 9099D. Since the 20 Agencies’ referred children were no longer attending the facility and the Plan of Corrections submitted today (2/1/2024). The deficiency was cleared at this same visit.

This report has been discussed and reviewed with the Director 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 report was reviewed with the licensee, Shuying Lin.

This report and a notice of site visit was given to the licensee and must remain posted for 30 day
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
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-20240131145536
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: APPLE TREE CHILDREN CENTER-INFANT
FACILITY NUMBER: 384004189
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/02/2024
Section Cited
CCR
101161(a)
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101161 Limitations on Capacity
(a)A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation.

This requirement is not met as evidenced by:
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Per the Director, the agencies’ referred 20 infants was no longer attending the facility since 2/1/2024. The Director would provide the plan to correct the deficiency by the POC due date (2/2/2024).
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Based on observation, interview and record review, the director admitted that the facility did not ensure the child care center operating within the capacity, which poses an immediate Health, Safety or Personal Rights risks to persons 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: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 02/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2