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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380503900
Report Date: 10/10/2023
Date Signed: 10/10/2023 04:13:16 PM


Document Has Been Signed on 10/10/2023 04:13 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:YMCA OF SF., MISSION BRANCH, MISSION PRESCHOOLFACILITY NUMBER:
380503900
ADMINISTRATOR:ALVAREZ, KATIAFACILITY TYPE:
850
ADDRESS:4080 MISSION STREETTELEPHONE:
(415) 586-6900
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:42CENSUS: 26DATE:
10/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Alexandra HallumTIME COMPLETED:
04:30 PM
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Licensing Program Analyst, LPA Yee conducted a case management visit today. Present at the facility are site director, 4 staff members and 26 children. On September 29, during transitation time, a parent was watching her child through a door window and claimed that her child was inappropriately grabbed/mishandled by a teacher. Today, LPA reviewed the video footage, and interviewed the site director. The video footage shows that the teacher looked as she had her hands on the child's shoulder or upper part of the body guiding him to get in line. And the teacher back was also against the window door at the time of the incident. Based on the video footage, LPA is unable to verify the claims. Therefore, no violation.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/10/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
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