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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 410518833
Report Date: 09/25/2024
Date Signed: 09/25/2024 11:41:37 AM

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
07/09/2024 and conducted by Evaluator Diana Alvarado
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240709114932
FACILITY NAME:FRIENDS TO PARENTS, INC.FACILITY NUMBER:
410518833
ADMINISTRATOR:DIREKZE, MERLAFACILITY TYPE:
830
ADDRESS:2525 WEXFORD AVENUETELEPHONE:
(650) 588-8212
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:51CENSUS: 27DATE:
09/25/2024
UNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Kaman "Carmen" LoTIME COMPLETED:
12:10 PM
ALLEGATION(S):
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Daycare child sustained multiple bites while in care.
INVESTIGATION FINDINGS:
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On 9/25/24 at approximately 8:45am, Licensing Program Analysts (LPAs) Alvarado and Tapia-Mandujano conducted an unannounced subsequent site visit to the facility to deliver investigation findings. LPAs Alvarado and Tapia-Mandujano met with Site Director, Kaman “Carmen” Lo and explained the purpose of the visit. Purpose of the visit was in response to the above allegation that was made to the Child Care Licensing Division (CCLD) on 7/9/24.

Present during the inspection was Site Director and ten staff supervising twenty-seven children (9 infants and 18 toddlers). During today’s visit, LPAs conducted a health and safety inspection of the facility. All adults present have fingerprint clearance and are associated to the facility.

During the course of the investigation, LPAs Alvarado and Tapia-Mandujano conducted confidential staff interviews, observations, and gathered documents that pertains to the current investigation. Based on LPAs observations, documents gathered, and interviews which were conducted it was determined that a child sustained multiple bites during a period while in care. Facility self-reported some biting incidents and acted by offering trainings and resources to staff and families.

Continued on Page 2..
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
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 3
Control Number 05-CC-20240709114932
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: FRIENDS TO PARENTS, INC.
FACILITY NUMBER: 410518833
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
10/25/2024
Section Cited
CCR
101223(a)(1)
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101223(a)(1): Personal Rights(a): "The licensee shall ensure that each child is accorded the following personal rights: (1)To be accorded dignity in his/her personal relationships with staff and other persons"

This requirement was not met as evidence by:
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Facility was proactive and offered trainings and resources for staff and families.

Director will submit documentation of trainings received by staff and have a written statement signed by all staff acknowledging they understand proper procedures to follow, including properly reporting incidents.
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Based on observation, interviews, and record review, the facility did not comply with the section cited above as a child sustained bites by peer while in care, which poses a potential Health, Safety, or Personal Rights to Persons in care.
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Director will email LPA Alvarado proof of trainings from all staff by 10/25/24.
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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: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20240709114932
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: FRIENDS TO PARENTS, INC.
FACILITY NUMBER: 410518833
VISIT DATE: 09/25/2024
NARRATIVE
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Page 2 Continued..

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. Type B citation has been issued today, September 25, 2024, in accordance with California Code of Regulations, Title 22, 101223(a)(1) Personal Rights are being cited on the attached LIC 9099D.

A plan of correction of this report, appeal rights, and notice of site visit were discussed and provided to Director Kaman “Carmen” Lo. Director was reminded that a Notice of Site visit (LIC 9213) must be posted for 30 consecutive days during the hours of operation after each site visit by a licensing representative Failure to maintain posting as required will result in a civil penalty of $100.00.

Exit interview was conducted, and a copy of this report was provided to the Director, Kaman “Carmen” Lo.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:

DATE: 09/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/25/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3