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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414000839
Report Date: 08/28/2026
Date Signed: 08/28/2026 05:24:07 PM

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
05/22/2026 and conducted by Evaluator Nathan Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260522130329
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: 77DATE:
08/28/2026
UNANNOUNCEDTIME BEGAN:
02:16 PM
MET WITH:Renata SheleyTIME COMPLETED:
05:25 PM
ALLEGATION(S):
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9
Staff did not ensure they were not out of ratio
Unqualified staff providing care to day care children
INVESTIGATION FINDINGS:
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On August 28, 2026, Licensing Program Analyst (LPA) Garcia arrived at the facility to conduct a complaint inspection in response to the above complaint allegation. LPA met with facility director, Renata Sheley. LPA explained purpose of inspection. There were 77 children present with the director and 9 staff members. At the time of arrival, LPA observed that there were 33 children in the cafeteria (NPR) with 3 unqualifid staff members through CCC. Based on LPA's interview with 3 staff members in the classroom, none of them were fully qualified staff members.

Based on interview, records reviewed, and observations, the preponderance of evidence standard has been met, therefore the above allegations are found SUBSTANTIATED.

***Continue to page 2***
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
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 4
Control Number 05-CC-20260522130329
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: 08/28/2026
NARRATIVE
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***Page 2 continued***

LPA Garcia informed facility director, Renata Sheley that this report dated 08/28/26 documents of two Type A citations which shall be posted for 30 consecutive days as there is immediate risks to the health, safety, or personal rights of children in care.

Also, LPA Garcia informed facility director, Renata Sheley to provide a copy of this licensing report dated 08/28/26 that documents any Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.

LPA was unable to print appeal rights due to technical error.
LPA conducted exit interview and report was given to facility director, Renata Sheley.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 05-CC-20260522130329
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: 08/28/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
08/31/2026
Section Cited
CCR
101216.2(e)
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101216.2:Teacher Aide Qualifications and Duties:
(e)An aide shall work only under the direct supervision of a teacher."

This requirement is not met as evidenced by:
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The other fully qualified staff from CCC was transferred to the cafeteria (NPR) to supervise the three staff members.
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Based on observation and interview, the facility did not comply with the section cited above as upon arrival, LPA observed that there were three aides supervising 33 school age children without the direct supervision of a fully qualified teacher. This poses an immediate health, safety or personal rights risk to persons in care.
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The supervision requirement was met after the qualified staff was moved to the cafeteria (NPR).

Deficiency cleared.
Type A
08/24/2026
Section Cited
CCR
101516.5(b)(1)
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101516.5: Teacher-Child Ratio:
(b) There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance. (1) A teacher shall supervise no more than 14 children or with an aide a maximum of 28 children.

This requirement is not met as evidenced by:
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According to facility director, they're unable to get another qualified staff. Therefore, LPA suggested to combine the two classrooms and have the other fully qualified staff to the cafeteria (NPR) to meet ratio requirements.
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Based on observation and interview, the facility did not comply with the section cited above as LPA observed there were 33 school age children in the 'NPR' with three aides. LPA interviewed the three staff members for ECE units and stated that they don't have complete units.
This poses an immediate health, safety or personal rights risk to persons in care.
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Once classrooms for TK/K and 1st-2nd grades were combined, the facility met the appropriate ratio.

Deficiency cleared.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
LIC9099 (FAS) - (06/04)
Page: 3 of 4
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
05/22/2026 and conducted by Evaluator Nathan Garcia
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260522130329

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: 77DATE:
08/28/2026
UNANNOUNCEDTIME BEGAN:
02:16 PM
MET WITH:Renata SheleyTIME COMPLETED:
05:25 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Staff are inappropriately recording day care children
Staff inappropriately make the children sit in silence
Staff are not meeting day care children's needs
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
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9
10
11
12
13
On August 28, 2026, Licensing Program Analyst (LPA) Garcia conducted unannounced complaint inspection. LPA met with site director, Renata Sheley and explained the purpose of the visit. Present during today's visit were 9 staff, including the director and 77 school-age children.

Based on interviews, record review and observations, the allegations mentioned above are unsubstantiated, meaning it may have happened or is valid, there is no preponderance of evidence to prove the violations did or did not occur.

Exit interview conducted and report was reviewed with site director, Renata Sheley.

A copy of the report was given to the site director, Renata Sheley.

LPA was unable to print appeal rights due to technical error.
Notice of Site Visit was provided and must remain posted for 30 days.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 08/28/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/28/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 4 of 4