210110016-1-8-2024-05-CC-GLEG-CZKVLV-20240117153231

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 210110016
Report Date: 10/11/2023
Date Signed: 01/08/2024 12:37:57 PM

Unsubstantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
09/01/2023 and conducted by Evaluator Nathan Garcia

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20230901115108

FACILITY NAME:	FAIRFAX SAN ANSELMO CHILDREN'S CENTER-INFANT PROGR		FACILITY NUMBER:	210110016
ADMINISTRATOR:	TOMSKY, HEIDI		FACILITY TYPE:	830
ADDRESS:	199 PORTEOUS AVENUE		TELEPHONE:	(415) 454-1811
CITY:	FAIRFAX	STATE: CA	ZIP CODE:	94930
CAPACITY:	19	CENSUS: 10	DATE:	10/11/2023
		UNANNOUNCED	TIME BEGAN:	10:01 AM
MET WITH:	Heidi Tomsky		TIME COMPLETED:	12:40 PM

ALLEGATION(S):

1
2
3
4
5
6
7
8
9

***** THIS IS AN AMENDED REPORT FROM ORIGINAL DATED 10/11/2023 *****
Staff do not have a current lease for the facility grounds.

INVESTIGATION FINDINGS:

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

***** THIS IS AN AMENDED REPORT FROM ORIGINAL DATED 10/11/2023 *****
On October 11, 2023, Licensing Program Analyst (LPA) Garcia and Licensing Program Manager (LPM) Oquendo conducted an unannounced conclusionary complaint visit and met with director, Heidi Tomsky and program director, Eric Schweninger to discuss the above allegation. The purpose of the inspection was explained. Present with the director were 10 children and 5 teachers in the infant program. The Preschool program had 18 children and 5 teachers. The school aged program was not in session during the visit.

During the visit, LPA and LPM observed and inspected the three licenses housed under the same property, preschool license number 210110015, school age license number 210110017 and the infant license number 210110016.

During the investigation, interviews were conducted, observations were made, and pertinent documentation was reviewed.

Although the above 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.

Report, Appeal Rights and Notice of Site Visit was provided.

Notice of Site Visit shall be posted for 30 consecutive days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Director, Hedi Tomsky.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 01/08/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/08/2024

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 1