<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004506
Report Date: 07/19/2022
Date Signed: 07/19/2022 11:47:32 AM

Unsubstantiated


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
06/01/2022 and conducted by Evaluator Winnie Ly
COMPLAINT CONTROL NUMBER: 05-CC-20220601132840
FACILITY NAME:LAKEVIEW MONTESSORIFACILITY NUMBER:
414004506
ADMINISTRATOR:BRAMHE, SHEILAFACILITY TYPE:
850
ADDRESS:31 VISTA AVENUETELEPHONE:
(650) 578-9532
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:61CENSUS: 40DATE:
07/19/2022
UNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Fida AslamTIME COMPLETED:
11:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff caused an injury to a daycare child while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On July 19, 2022 at approximately 9:45am, Licensing Program Analyst (LPA) Winnie Ly conducted a conclusionary complaint visit at this location. LPA met with Assistant Director Fida Aslam. The purpose of the visit was explained. There were 8 staff caring for 40 children.

Based on information obtained during the course of this investigation through interviewed staff, interviewed victim's parent and police report, there was no sufficient evidence to prove allegation staff caused an injury to a daycare child while in care. Although the allegation 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.

This report was reviewed with Assistant Director whose signature confirm have read the report. Report must be made available for public review upon request. A copy of the report as well as the notice of site visit will be emailed to the Facility Representative. Notice of site visit shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 07/19/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/19/2022
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 3