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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 410500701
Report Date: 09/21/2022
Date Signed: 09/21/2022 01:47:40 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
09/13/2022 and conducted by Evaluator Marie Rodriguez
COMPLAINT CONTROL NUMBER: 05-CC-20220913144707

FACILITY NAME:WOODSIDE PARENTS' NURSERY SCHOOLFACILITY NUMBER:
410500701
ADMINISTRATOR:TRUDELL, KARENFACILITY TYPE:
850
ADDRESS:3154 WOODSIDE ROADTELEPHONE:
(650) 851-7112
CITY:WOODSIDESTATE: CAZIP CODE:
94062
CAPACITY:44CENSUS: 26DATE:
09/21/2022
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Daran ReinholmTIME COMPLETED:
02:15 PM
ALLEGATION(S):
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- Facility does not have its license posted in a prominent, publicly accessible location in the center.
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Marie Rodriguez conducted an unannounced inspection to open a complaint in-conjunction with an annual inspection. LPA met with Site Supervisor Daran Reinholm and explained purpose of inspection. Present at the facility were the Site Supervisor, three teachers, one teacher's assistant, four parent teachers, and 26 preschool children.

During the course of the investigation, LPA toured the facility with Site Supervisor and conducted interviews. It was found that facility's license was located inside the office and a copy was not posted anywhere else within the facility.

Based on information gathered, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

Deficiency cited today under California Code of Regulations, Title 22, Division 12, follows on LIC 9099D.

Exit interview was conducted and report was discussed with Site Supervisor Daran Reinholm. Appeals Rights were given and explained. A copy of report was provided.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 4
Control Number 05-CC-20220913144707
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: WOODSIDE PARENTS' NURSERY SCHOOL
FACILITY NUMBER: 410500701
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/21/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/07/2022
Section Cited
CCR
101660(a)
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Posting of License
The license shall be posted in a prominent, publicly accessible location in the center.

This requirement has not been met as evidenced by:
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Facility plans to post license on a bulletin board outside the classroom.
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Based on observation, it was found that the facility's license was located inside the office and not in a publicly accessible location within the facility which poses a potential safety 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: Daniel J Oquendo
LICENSING EVALUATOR NAME: Marie Rodriguez
LICENSING EVALUATOR SIGNATURE:

DATE: 09/21/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/21/2022
LIC9099 (FAS) - (06/04)
Page: 4 of 4