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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 415600980
Report Date: 09/09/2026
Date Signed: 09/09/2026 02:37:13 PM

Unsubstantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO 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
08/11/2026 and conducted by Evaluator Murial Han
PUBLIC
COMPLAINT CONTROL NUMBER: 14-AS-20260811135555
FACILITY NAME:ATRIA AT FOSTER SQUAREFACILITY NUMBER:
415600980
ADMINISTRATOR:FREDDIE FULLONFACILITY TYPE:
740
ADDRESS:707 THAYER LNTELEPHONE:
(650) 532-2460
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY:0CENSUS: 0DATE:
09/09/2026
UNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Administrator, Freddie FullonTIME COMPLETED:
02:40 PM
ALLEGATION(S):
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Staff worked at the facility while under the age of eighteen
INVESTIGATION FINDINGS:
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On Septemeber 9, 2026, Licensing Program Analyst (LPA) Murial Han conducted an unnannounced visit to deliver the complaint investigation findings. LPA met with the administrator and LPA explained the purpose of today's visit.

Regarding the allegation of- staff worked at the facility while under the age of eighteen, there is no additional information forthcoming from the reporting party. However, during the initial reporting, the reporting party stated that staff #1 (S1) was a minor in mid- February while working at the facility.

The administrator stated that S1 was a minor when he/she was hired, however, S1 was hired as a waitstaff who did not require nor perform any care and supervision of the residents. The administrator also stated that S1 is no longer working at the facility.

Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2026
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 2
Control Number 14-AS-20260811135555
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: ATRIA AT FOSTER SQUARE
FACILITY NUMBER: 415600980
VISIT DATE: 09/09/2026
NARRATIVE
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Based on S1’s hiring application and new hire on boarding checklist, S1 was hired as a waitstaff.

Based on S1’s job description, the duties and responsibilities did not require care and supervision of residents.

The facility also provided a copy of the signed work permit for S1 as S1 was hired as a minor.

After the investigation, this allegation is deemed to be unsubstantiated as S1 did not supervise or care for residents.

Although the above allegations may have happened or are valid, there is not a preponderance of evidence to prove the alleged violations did or did not occur, therefore the allegation is UNSUBSTANTIATED.

This report is review with the administrator and a copy is provided
SUPERVISORS NAME: April Cowan
LICENSING EVALUATOR NAME: Murial Han
LICENSING EVALUATOR SIGNATURE:

DATE: 09/09/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/09/2026
LIC9099 (FAS) - (06/04)
Page: 2 of 2