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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384004749
Report Date: 04/23/2026
Date Signed: 04/23/2026 04:43:20 PM

Unsubstantiated


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
10/23/2025 and conducted by Evaluator Brendon Van
COMPLAINT CONTROL NUMBER: 05-CC-20251023130631
FACILITY NAME:WU, XIULINGFACILITY NUMBER:
384004749
ADMINISTRATOR:WU, XIULINGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 324-9002
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY:14CENSUS: 8DATE:
04/23/2026
UNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:XiuLing WuTIME COMPLETED:
04:55 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
The child sustained injuries resulting in hospitalization.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 23, 2026, Licensing Program Analyst (LPA) Van conducted an unannounced visit to deliver the complaint investigation findings and met with the licensee, XiuLing Wu. Present during the visit was the licensee supervising 8 children. Among the 8 children, 3 were infants, and 5 were preschool-aged. The husband arrived during the inspection, and another assistant arrived approximately 50 minutes after.

Investigations Bureau (IB) Investigator Victoria McIntosh conducted the investigation. During the investigation, IB Investigator McIntosh conducted interviews with Cross Reporting Agencies, obtained Police records and a Patient care report from SFFD, and reviewed all relevant information, including medical records.

Based on the information obtained during the investigation, there was insufficient evidence to prove the allegation listed above. Although the allegation may have happened or is valid, there is no preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days.
An exit inspection was conducted with the licensee, XiuLing Wu. The report was provided to the licensee.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 04/23/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/23/2026
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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