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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 410518747
Report Date: 06/14/2023
Date Signed: 06/14/2023 01:39:27 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
04/18/2023 and conducted by Evaluator Leslit Tapia-Mandujano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230418082937
FACILITY NAME:RCSD CHILD DEV SERVICES-HOOVER STATE PRESCHOOLFACILITY NUMBER:
410518747
ADMINISTRATOR:PENA, ROXANAFACILITY TYPE:
850
ADDRESS:701 CHARTER ST, PORT 1,2,3,& 4TELEPHONE:
(650) 482-2407
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY:105CENSUS: 56DATE:
06/14/2023
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Site Supervisor, Roxana PenaTIME COMPLETED:
02:15 PM
ALLEGATION(S):
1
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5
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9
Staff do not maintain proper teacher-child ratios
INVESTIGATION FINDINGS:
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2
3
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5
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9
10
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13
On June 14th at approximately 11:30am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, complaint investigation and met with Site Supervisor, Roxana Pena regarding above allegations and explained the purpose of the visit. LPA and Site Supervisor toured the facility for health and safety hazards and LPA conducted Staff interviews.

Complaint was received by the Department on 04/18/23. Present in the facility are Site Supervisor and 10 teachers caring for 56 preschool age children. All adults working or living in the facility have fingerprint clearance and are associated through the School District.

During the course of the investigation, interviews were conducted with parents and staff, and relevant documents were gathered. LPA also did unannounced inspections in three different occasions. Per interviews, documentation, and observations, it was determined that staff were maintaing proper teacher-child ratios.

Although the allegation above may have happened or is valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore, the above allegations are UNSUBSTANTIATED.

Upon receipt of this report, Licensee shall post the Notice of Site Visit. The report and the Notice of Site Visit shall be posted for 30 consecutive days. Failure to maintain postings as required, will result in an immediate $100 civil penalty. This report is public and can be reviewed.

After today’s visit, an exit interview was conducted, report was reviewed and copy was provided to Site Supervisor, Roxana Pena.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
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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