410509769-6-16-2026-05-CC-AZEA-DVUN8T-20260710101450

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 410509769
Report Date: 06/16/2026
Date Signed: 06/16/2026 01:26:22 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
04/23/2026 and conducted by Evaluator Diana Alvarado

COMPLAINT CONTROL NUMBER: 05-CC-20260423144122

FACILITY NAME:	CSSF REC DEPT-SIEBECKER CENTER		FACILITY NUMBER:	410509769
ADMINISTRATOR:	ALENI CAPAZ		FACILITY TYPE:	850
ADDRESS:	510 ELM COURT		TELEPHONE:	(650) 875-6979
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	55	CENSUS: 36	DATE:	06/16/2026
		UNANNOUNCED	TIME BEGAN:	09:07 AM
MET WITH:	Site Supervisor, Aleni Capaz, Recreation Community Supervisor, Kimberly Morrison and Supervisor, Diana Gonzalez for Preschool & Early Learning		TIME COMPLETED:	01:50 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

Child sustained injuries while in care.

INVESTIGATION FINDINGS:

1
2
3
4
5
6
7
8
9
10
11
12
13

On June 16, 2026 at approximately at 9:00AM, Licensing Program Analysts (LPA) Alvarado conducted an unannounced, subsequent site visit to the facility to deliver investigation findings in response to the above allegation that was made to the Child Care Licensing Division (CCLD) on April 23, 2026. LPA Alvarado met with Site Supervisor, Aleni Capaz(D1), Recreation Community Supervisor, Kimberly Morrison(S1) and Supervisor, Diana Gonzalez for Preschool & Early Learning(S2) LPA discussed the purpose of the visit. All staff present have Criminal Record Clearance.

During today’s visit, LPA conducted a health and safety inspection indoors and outdoors along with the Facility Representatives (D1), (S1), and (S2). Present during the inspection was (D1) and six staff members supervising thirty-six children Preschool age. Facility is a large classroom that splits into three groups (Jellyfish Moon), (Blue Jays), and (Superhero’s).

Continued on Page 2...

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026

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-20260423144122

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: CSSF REC DEPT-SIEBECKER CENTER	FACILITY NUMBER: 410509769
	VISIT DATE: 06/16/2026

NARRATIVE

1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32

During the course of the investigation, LPA conducted classroom observations, gathered documents, and interviewed random selection of staff and Parents. Through staff interviews it was determined that a Child did not sustained injuries while in care. Based on the information gathered it was determined that there is not sufficient evidence to say that Child sustained injuries while in care. Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

No deficiencies are being cited today under California Code of Regulations, Title 22.

A notice of site visit was given and must remain posted for 30 days. Appeal Rights were provided to (D1).

Exit interview conducted and report was reviewed with Facility Representatives, Aleni Capaz(D1), Kimberly Morrison(S1) and Diana Gonzalez.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:	DATE: 06/16/2026

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2026

LIC9099 (FAS) - (06/04)

Page: 2 of 2