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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002826
Report Date: 08/14/2023
Date Signed: 08/14/2023 12:51:40 PM

Substantiated


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
08/08/2023 and conducted by Evaluator Cindy Mok
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230808095730
FACILITY NAME:LEBOEUF, LISE AND ALLAUME, CELINEFACILITY NUMBER:
384002826
ADMINISTRATOR:FACILITY TYPE:
810
ADDRESS:TELEPHONE:
CITY:STATE: ZIP CODE:
CAPACITY:6CENSUS: 17DATE:
08/14/2023
UNANNOUNCEDTIME BEGAN:
09:55 AM
MET WITH:Lise Leboeuf TIME COMPLETED:
01:20 PM
ALLEGATION(S):
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Over Capacity
INVESTIGATION FINDINGS:
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Licensing Program Analyst (LPA) Mok conducted an inspection to open this complaint. LPA met with the licensee, Lise Leboeuf, and a helper; both of them had fingerprint clearance. LPA explained the purpose of the inspection to the licensee. LPA observed 17 children including a preschooler with a licensee and a helper presence during the inspection. All audlts had fingerprint clearance.

Based on LPAs observations, 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 & Chapter 3), are being cited on the attached LIC 9099D.”
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
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 2
Control Number 05-CC-20230808095730
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LEBOEUF, LISE AND ALLAUME, CELINE
FACILITY NUMBER: 384002826
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/15/2023
Section Cited
CCR
102416.5(a)(c)
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102416.5 (a)(c) Staffing Ratio and Capacity
(a) The capacity specified on the license shall be the maximum number of children for whom care may be provided at any one time.(c) The total licensed capacity for a Small Family Child Care Home shall not exceed eight children.
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Licensee must reduce the number of children within the capacity at any time by the due date (8/15/2023).
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LPA observed 17 children including a preschooler with a licensee and a helper during the inspection. This poses a potential health risk to children in care.
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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: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2