384004434-10-6-2022-05-CC-GLEG-CK52GG-20221011172307

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384004434
Report Date: 10/06/2022
Date Signed: 10/06/2022 09:46:49 AM

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
07/18/2022 and conducted by Evaluator Brendon Van

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20220718094359

FACILITY NAME:	NOE VALLEY KIDS		FACILITY NUMBER:	384004434
ADMINISTRATOR:	TOLEDO, JORDAN		FACILITY TYPE:	830
ADDRESS:	3800 22ND STREET		TELEPHONE:	(415) 619-2293
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94114
CAPACITY:	32	CENSUS: 17	DATE:	10/06/2022
		UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Chuan Mei Tan and Miranda Pan		TIME COMPLETED:	10:00 AM

ALLEGATION(S):

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-Child sustained injury while in care
-Facility staff allowed child to play on unsafe play structure

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Van conducted an unannounced inspection to finalize this complaint and delivery the findings to the Center. LPA met with the Lead Teacher, Chuan Mei Tan. The Site Director was not present. The owner, Miranda Pan arrived during the visit. The purpose of the inspection was explained, and entry to the Center was granted. Six teachers supervised 17 children today. The teachers and children ratio was met.
As part of the investigation, LPA interviewed parents of children attending the Center and staff members; Conducted several surveillance visits at Noe Vally Court Park, including random interviews of parents at the Park who allegedly had knowledge of children playing on an unappropriate-age play structure, which resulted in a child sustained injury. Based on interviews, there was conflicting information on whether the child was from Noe Valley Kids Preschool, and the location where the child fell was not consistent. In addition, staff members denied any child fell at the Noe Valley Court Park. Staff members' Declaration was reviewed and obtained. Parents confirmed that the Center promptly informed them of any injury/accidental fall of their child when it occurred, and they were aware the Center utilized the Noe Valley Court Park.
Although the allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur. Therefore, the allegations are Unsubstantiated. An exit inspection was conducted with the Owner. A copy of the report was provided to the Owner at the conclusion of the inspection. LPA informed the Owner that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Unsubstantiated

Estimated Days of Completion:

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 10/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/06/2022

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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