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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004607
Report Date: 01/16/2025
Date Signed: 04/17/2025 12:52:56 PM

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
01/13/2025 and conducted by Evaluator Jennifer Yee
COMPLAINT CONTROL NUMBER: 05-CC-20250113152349
FACILITY NAME:CHEN, HELEN Y.FACILITY NUMBER:
384004607
ADMINISTRATOR:CHEN, HELEN Y.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 385-9552
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:14CENSUS: 11DATE:
01/16/2025
UNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Helen ChenTIME COMPLETED:
12:00 PM
ALLEGATION(S):
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Licensee does not reside in daycare home
INVESTIGATION FINDINGS:
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***** THIS IS AN AMENDED REPORT FROM ORIGINAL DATED 01/16/2025 *****

Licensing Program Analyst, LPA Yee and Tso conducted a visit to open a complaint. The purpose of the visit was explained. There are 2 helpers and 11 children. The licensee, Helen was not present upon arrival. The licensee, Helen arrived 15 minutes later. Today, LPAs inspected the entire home.

LPAs and the licensee inspected the home for Health and Safety Hazards. The licensee was interviewed.

Although the allegation of ‘Licensee does not reside in the daycare home’ may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

An amended report is provided to Licensee for signature. Original signature on file. Report must be made available for public review upon request. A copy of this report and rights to comment and appeal have been discussed and left with the Licensee. Notice of Site Visit shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion: 90
SUPERVISORS NAME: Carol Marcroft
LICENSING EVALUATOR NAME: Cindy Interiano
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
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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Control Number 05-CC-20250113152349
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: CHEN, HELEN Y.
FACILITY NUMBER: 384004607
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/16/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Deficiency Dismissed
Type B
01/24/2025
Section Cited
CCR
102352(h)(1)(a)(b)
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102352(h)(1)(a)(b):Home" means the licensee's residence as defined by Government Code Section 244.It is the place where one remains when not called elsewhere for labor or other special or temporary purpose, and to which he or she returns in seasons of repose.

(b) There can only be one residence.
This requirement is not met as evidenced by
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Office meeting is scheduled for 1-24-2025. The licensee may discuss the issues with the Regional Manager.
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Based on the interviews and physical inspection, conducted during today’s inspection the licensee does not live here, which poses potential health, safety, or personal rights 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: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
LIC9099 (FAS) - (06/04)
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