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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414000839
Report Date: 02/20/2026
Date Signed: 02/20/2026 02:58:03 PM

Unsubstantiated


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
01/09/2026 and conducted by Evaluator Leslit Tapia-Mandujano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260109093246
FACILITY NAME:CHAMPIONS-JOHN MUIR ELEMENTARY (SA)FACILITY NUMBER:
414000839
ADMINISTRATOR:TREVISAN, NOELFACILITY TYPE:
840
ADDRESS:130 CAMBRIDGE LANETELEPHONE:
(650) 797-4310
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY:120CENSUS: 25DATE:
02/20/2026
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH: Melanie MurphyTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Licensee did not ensure doorways were unobstructed.
Licensee did not maintain outdoor areas free of debris.
INVESTIGATION FINDINGS:
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On February 20th, 2026, at approximately 9:10am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced complaint visit to the facility. LPA met with Site Supervisor at Allen, Bridget Gauthier and newly hired Site Supervisor, Melanie Murphy and explained the purpose of the visit.

Facility is an afterschool program that is operating full day this week due to Elementary School being out for Ski week. Upon arrival, there were two champion staff present in the facility. During inspection, three other Champion staff arrived at the facility. LPA observed there were 25 school-age children present. LPA observed that there are three staff not associated with the facility.

During the course of the investigation, LPA conducted interviews with staff, conducted health and safety inspections. LPA also received pertinent documentation. LPA determined that based on the information obtained there is not sufficient evidence to prove the following allegations of facility ensuring the doorways were unobstructed and that facility did not maintain outdoor areas free of debris.

Continued on Page 2...
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
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 5
Control Number 05-CC-20260109093246
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: CHAMPIONS-JOHN MUIR ELEMENTARY (SA)
FACILITY NUMBER: 414000839
VISIT DATE: 02/20/2026
NARRATIVE
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Page 2 Continued...

Although the above allegation may have happened or is valid, based on LPA's observations, interviews and record review which were conducted, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with newly hired site supervisor, Melanie Murphy.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 5
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
01/09/2026 and conducted by Evaluator Leslit Tapia-Mandujano
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260109093246

FACILITY NAME:CHAMPIONS-JOHN MUIR ELEMENTARY (SA)FACILITY NUMBER:
414000839
ADMINISTRATOR:TREVISAN, NOELFACILITY TYPE:
840
ADDRESS:130 CAMBRIDGE LANETELEPHONE:
(650) 797-4310
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY:120CENSUS: 25DATE:
02/20/2026
UNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH: Melanie MurphyTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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Facility was observed to have pests inside classroom.
INVESTIGATION FINDINGS:
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On February 20th, 2026, at approximately 9:10am, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced complaint visit to the facility. LPA met with Site Supervisor at Allen, Bridget Gauthier and newly hired Site Supervisor, Melanie Murphy and explained the purpose of the visit.

Facility is an afterschool program that is operating full day this week due to Elementary School being out for Ski week. Upon arrival, there were two champion staff present in the facility. During inspection, three other Champion staff arrived at the facility. LPA observed there were 25 school-age children present. LPA observed that there are three staff not associated with the facility.

During the course of the investigation, LPA conducted interviews with staff, conducted health and safety inspections. LPA also received pertinent documentation. Based on the interviews conducted, LPA has determined that the facility was observed to have pests inside classroom.

Continued on Page 2...
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 5
Control Number 05-CC-20260109093246
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: CHAMPIONS-JOHN MUIR ELEMENTARY (SA)
FACILITY NUMBER: 414000839
VISIT DATE: 02/20/2026
NARRATIVE
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Page 2 Continued...

Based on interviews and record review which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.

California Code of Regulations, Title 22, Division 12, are being cited. Please refer to 9099D for more information.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with newly hired site supervisor, Melanie Murphy.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
LIC9099 (FAS) - (06/04)
Page: 4 of 5
Control Number 05-CC-20260109093246
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: CHAMPIONS-JOHN MUIR ELEMENTARY (SA)
FACILITY NUMBER: 414000839
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/20/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/06/2026
Section Cited
CCR
101238(a)(1)
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101238: Building and Grounds: "(a): The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors. (1) The licensee shall take measures to keep the center free of flies, other insects, and rodents."

This requirement was not met as evidenced by:
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Facility will submit the work orders that were created to take care of the rodents issue.

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Based on interviews, the facility did not comply with section cited above as staff had observed there to be mice and droppings of mice inside one of the classrooms. This posed a potential health, safety or personal rights risk to children in care.
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Facility will submit a written plan on what measure will be and are being taken to ensure that the facility is free of rodents for children, employees, and visitors.

Written plan must be submitted to LPA Tapia-Mandujano at the office by 3/06/26.
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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: Marie Rodriguez
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 02/20/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2026
LIC9099 (FAS) - (06/04)
Page: 5 of 5