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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004890
Report Date: 02/21/2025
Date Signed: 02/27/2025 11:37:17 AM

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
11/14/2024 and conducted by Evaluator Janet Gil
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20241114110353
FACILITY NAME:SOBIESKI, GRACEFACILITY NUMBER:
414004890
ADMINISTRATOR:SOBIESKI, GRACEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(831) 566-8595
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:14CENSUS: 8DATE:
02/21/2025
UNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Grace SobeskiTIME COMPLETED:
01:20 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Adult resident's conduct poses a risk to children in care.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On Feburary 27th, 2025, at approximatly 11:00 AM, Licensing Program Analyst (LPA) Gil conducted an unannounced inspection in order to deliver findings on the complaint investigation for the above allegation. LPA Gil met with licensee, Grace Sobieski to discuss complaint allegations findings. Present during LPA’s visit included licensee, licenee's spouse, 1 assistant, and 9 children (6 preschoolers, 3 infants). All adults living or working in the home have on file fingerprint clearance.

Based on LPA record reviews, and interviews which were conducted. The allegation may have happened or is valid, however there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.

Exit interview was conducted and a copy of this report was reviewed and provided to the licensee, Grace Sobieski.

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations.

NOTICE OF SITE VISIT WAS GIVEN AND SHALL REMAIN 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: Janet Gil
LICENSING EVALUATOR SIGNATURE:

DATE: 02/21/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/21/2025
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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