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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004591
Report Date: 07/15/2026
Date Signed: 07/15/2026 01:34:48 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
05/11/2026 and conducted by Evaluator Man Tso
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20260511153258

FACILITY NAME:BUILDING KIDZ PACIFICAFACILITY NUMBER:
414004591
ADMINISTRATOR:MERCADO, CHRISTINEFACILITY TYPE:
850
ADDRESS:401 PALOMA AVENUETELEPHONE:
(650) 557-1256
CITY:PACIFICASTATE:CAZIP CODE:
94044
CAPACITY:72CENSUS: 26DATE:
07/15/2026
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Assistant Director, Sharon CabilatazanTIME COMPLETED:
01:50 PM
ALLEGATION(S):
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Staff served expired food to the daycare children.
Staff did not provide adequate food service to the daycare children.
INVESTIGATION FINDINGS:
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On July 15, 2026, at approximately 12.00PM, Licensing Program Analyst (LPA) Tso conducted an unannounced subsequent complaint investigation to deliver the findings and met with the Assistant Director, Sharon Cabilatazan. LPA explained the purpose of the inspection and were granted entry to the facility by the licensee. Present, Assistant Director, 5 teachers and 26 children.

Based on LPA’s gathered information through observation, interviews and records reviews, the agency has investigated the complaint allegation above. The facility did not comply with the Food Services regulations. The preponderance of evidence standard has been met. The above allegations are found to be SUBSTANTIATED. A Type B violation was issued today, July 15, 2026 in accordance with the California Code of Regulations, Title 22, Division 12, citation was being cited on the attached LIC 9099D.

Exit interview conducted and a copy of this report and appeal rights were discussed and left with the Assistant Director, Sharon Cabilatazan, whose signature on this form confirms receipt of these reports. Notice of Site Visit (The Notice) was provided. The Notice is to remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20260511153258
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: BUILDING KIDZ PACIFICA
FACILITY NUMBER: 414004591
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/15/2026
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/07/2026
Section Cited
CCR
101227(a)(1)
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101227 Food Services (a) In child care centers providing meals to children, the following shall apply: (1) All food shall be safe and of the quality and in the quantity necessary to meet the needs of the children. Each meal shall include, at a minimum, the amount of food components… Requirements for Meals, for the age group served. All food shall be selected, stored, prepared and served in a safe and healthful manner.

This requirement is not met as evidenced by:
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The Director should train staff on the requirements of Food Services and email LPA agenda and a signature of all in attendance by 08/07/2026.
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Based on observation, interviews and record review, the facility did not comply with the section cited above that the facility stored the bread which lapsed the date “best by” in the freezer to be planned for serving to the children in care. There was insufficient food to be served at lunch for the children in care, which poses/posed a potential health, safety, or personal rights risk to persons 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.
SUPERVISOR'S NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:

DATE: 07/15/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2026
LIC9099 (FAS) - (06/04)
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