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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004693
Report Date: 04/26/2021
Date Signed: 04/26/2021 04:21:55 PM

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
03/15/2021 and conducted by Evaluator Winnie Ly
COMPLAINT CONTROL NUMBER: 05-CC-20210315164957
FACILITY NAME:KUO, WAN YUFACILITY NUMBER:
414004693
ADMINISTRATOR:KUO, WAN YUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 380-8555
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:14CENSUS: 12DATE:
04/26/2021
UNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Wan Yu Kuo (aka Alice)TIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff used inappropriate form of discipline with day care child.
Lack of supervision.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Due to COVID-19 and DPH guidelines of social distancing, Licensing Program Analyst (LPA) Winnie Ly conducted a teleconference with Licensee Wan Yu Kuo (aka Alice) on April 26, 2021 to close this complaint. During this investigation, LPA interviewed complainant, licensee, victims, parents and staff. As part of this investigation, LPA also collected children’s roster, staff roster and parent's handbook.

Based on the information obtained, although the allegations staff used inappropriate form of discipline with day care child and lack of supervision may have happened or may be valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore, the above allegations are found to be Unsubstantiated.

This report has been explained to the licensee and will be emailed to Licensee. Licensee has been advised to acknowledge received of reports.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2021
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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