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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414001763
Report Date: 04/12/2023
Date Signed: 04/12/2023 03:44:57 PM

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
11/23/2022 and conducted by Evaluator Catrina Quimbo
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20221123080600
FACILITY NAME:KUNG, SHERRY LIUFACILITY NUMBER:
414001763
ADMINISTRATOR:KUNG, SHERRY LIUFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 570-6966
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:14CENSUS: 5DATE:
04/12/2023
UNANNOUNCEDTIME BEGAN:
02:40 PM
MET WITH:Sherry Liu KungTIME COMPLETED:
04:00 PM
ALLEGATION(S):
1
2
3
4
5
6
7
8
9
Day care child sustained unexplained skull fracture.
INVESTIGATION FINDINGS:
1
2
3
4
5
6
7
8
9
10
11
12
13
On April 12, 2023 at approximately 2:40pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, complaint visit. LPA met with licensee, Sherry Liu Kung, and explained the purpose of the visit.

Present during visit included licensee, licensee's assistant and 5 children (1 preschool age and 4 infants). Licensee is a large family child care home and is operating within capacity limits and ratio during LPA's visit.

Investigations Bureau (IB) conducted the investigation. During the investigation, IB Investigator conducted interviews with licensee, staff, enrolled day care children’s parents and cross reporting agencies. IB Investigator also obtained supportive information and documents.

Per staff interviewed, an enrolled child did not fall or develop an injury in licensee’s care. Per parents interviewed, they are comfortable with their children at facility and find facility to be safe. Per records obtained, there is no clear indication how child received injury.

Although the above allegation may have happened or is valid, based on information obtained by IB Investigator, 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 the licensee, Sherry Liu Kung.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 04/12/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/12/2023
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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