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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 213003961
Report Date: 11/15/2024
Date Signed: 11/15/2024 01:48:38 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
09/23/2024 and conducted by Evaluator Hanson Leong
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240923165119
FACILITY NAME:CITY OF SAN RAFAEL - PARKSIDE CHILDREN'S CENTERFACILITY NUMBER:
213003961
ADMINISTRATOR:MCGRATH, KELLYFACILITY TYPE:
850
ADDRESS:51 ALBERT PARK LANETELEPHONE:
(415) 485-3388
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:50CENSUS: 34DATE:
11/15/2024
UNANNOUNCEDTIME BEGAN:
01:08 PM
MET WITH:Jackie NewsomTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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9
Child was touched inappropriately by staff.
INVESTIGATION FINDINGS:
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5
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7
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13
On 11/15/2024, Licensing Program Analysts (LPAs) Leong and Naves conducted an unannounced complaint visit and met with the Director, Jackie Newsom. The purpose of the visit was to deliver the findings and to close out the complaint. LPAs explained the purpose of the visit to the director.

Thirty-four preschool-aged children and seven staff members were present during today’s visit.

All relevant information was collected and analyzed during the LPA investigation, and all parties involved were contacted and interviewed. Based on the information obtained from the LPA investigation, the allegation listed above was unsubstantiated, meaning it may have happened or is valid, there is no preponderance of evidence to prove the violations did or did not occur.

See page 2

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
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 2
Control Number 05-CC-20240923165119
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CITY OF SAN RAFAEL - PARKSIDE CHILDREN'S CENTER
FACILITY NUMBER: 213003961
VISIT DATE: 11/15/2024
NARRATIVE
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Page 2

No deficiencies were issued today during LPA's visit.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Jackie Newsom.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 2