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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214005611
Report Date: 07/25/2024
Date Signed: 07/25/2024 09:44:18 AM

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
06/10/2024 and conducted by Evaluator Hanson Leong
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240610163242
FACILITY NAME:GONCHAROUK, IRINAFACILITY NUMBER:
214005611
ADMINISTRATOR:GONCHAROUK, IRINAFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 990-3911
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:14CENSUS: 10DATE:
07/25/2024
UNANNOUNCEDTIME BEGAN:
09:19 AM
MET WITH:Irina GoncharoukTIME COMPLETED:
10:00 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained unexplained injuries while in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On 7/25/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced complaint visit to the Family Childcare Home (FCCH) listed above. The purpose of the visit was to deliver the findings and to close out the complaint. LPA met with the Licensee, Irina Goncharouk, and explained the purpose of the visit.

Ten children (four school-aged and six pre-k) and three adults (the Licensee and the Licensee's two assistants) were present in the home. The licensee holds a large license and is within capacity limits and ratio.

During the LPA investigation, all relevant information was collected and analyzed, and all parties involved were contacted and interviewed. Based on the information obtained from the LPA investigation, the June 2024 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.

A copy of today’s report was given to the Licensee, Irina Goncahrouk. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Licensee, Irina Goncahrouk.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/25/2024
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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