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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414000931
Report Date: 03/15/2024
Date Signed: 03/15/2024 10:19:02 AM

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
01/26/2024 and conducted by Evaluator Andrea Medlin
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240126145544
FACILITY NAME:IHSD, INC-SOUTH SAN FRANCISCO HEAD START CENTERFACILITY NUMBER:
414000931
ADMINISTRATOR:YESSENIA FLORES-GUZMANFACILITY TYPE:
850
ADDRESS:825 SOUTHWOOD DRIVETELEPHONE:
(650) 368-1728
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:80CENSUS: DATE:
03/15/2024
UNANNOUNCEDTIME BEGAN:
08:25 AM
MET WITH:Yessenia Flores-GuzmanTIME COMPLETED:
10:35 AM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
PERSONAL RIGHTS: Staff caused injuries to daycare child
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this conclusionary complaint visit. Purpose of visit explained. Information obtained and interviews conducted. Based on information gathered and interviews, there is no evidence that the child (C1) was hurt/hit or otherwise caused injury by any staff person. All staff interviews revealed that staff are unaware of any incident regarding injury to this child at the facility. The reporting party brought up a concern of "scratches" on the child but is unknown where this occured at. Based on the investigation, it was determined there was a lack of sufficient evidence to support or deny the allegation. Based on this information, the findings of the allegation is unsubstantiated.

This report was reviewed with facility representative and a copy of this report must be made available for public review upon request.

Notice of site visit posted and shall remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Andrea Medlin
LICENSING EVALUATOR SIGNATURE:

DATE: 03/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/15/2024
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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