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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 214200082
Report Date: 12/02/2025
Date Signed: 12/02/2025 02:40:51 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
09/22/2025 and conducted by Evaluator Jaclyn Naves
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20250922163251
FACILITY NAME:GOCHBERG, JODIFACILITY NUMBER:
214200082
ADMINISTRATOR:JODI GOCHBERGFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 250-8465
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY:14CENSUS: 6DATE:
12/02/2025
UNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Jodi GochbergTIME COMPLETED:
02:45 PM
ALLEGATION(S):
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staff spoke to children in an inappropriate manner
INVESTIGATION FINDINGS:
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On December 2, 2025, Licensing Program Analysts (LPAs) Naves and Van conducted an unannounced inspection to finalize this complaint and deliver the findings to the Licensee. LPAs explained the purpose of the visit, and entry was granted. Licensee supervised 6 children (3 infant 3 preschool age).

As part of the investigation, staff, parents and other persons of interest were interviewed, and all relevant documents were obtained and reviewed. Based on the information available, it was determined the allegation that staff spoke to children in an inappropriate manner occurred. The preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12 are being cited.

Please refer to 9099D for more information.

Appeal rights given.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Licensee Jodi Gochberg.


Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jaclyn Naves
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
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-20250922163251
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GOCHBERG, JODI
FACILITY NUMBER: 214200082
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/02/2025
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
12/02/2025
Section Cited
CCR
102423(a)4
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102423 Personal Rights(a)Each child receiving services from a family child care home shall have certain rights that shall not be waived or abridged by the licensee regardless of consent or authorization from the child's authorized representative. These rights include, but are not limited to, the following: (4)To be free from corporal or unusual punishment, infliction of pain, humiliation, intimidation, ridicule, coercion, threat, mental abuse, or other actions of a punitive nature, including, but not limited to: interference with eating, sleeping or toileting; or withholding shelter, clothing, medication or aids to physical functioning.
This requirement was not met as evidence by:
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Licensee will review Children Personal rights regulation with staff, and will submit to LPA a written plan on what she will do to prevent this from happening again by end of business day on December 12,2025.
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Based on interview and record review. The licensee did not comply with cited section above as it was observed and reported by a concerned citizen that the Licensee was speaking to children in an innapropritate manner. This action pose(s) a potential health, and safety risks to children in care.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jaclyn Naves
LICENSING EVALUATOR SIGNATURE:

DATE: 12/02/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/02/2025
LIC9099 (FAS) - (06/04)
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