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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504444
Report Date: 04/23/2024
Date Signed: 04/23/2024 02:50:09 PM


Document Has Been Signed on 04/23/2024 02:50 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:SFUSD JOHN MCLAREN EARLY ED. SCHOOL (PRESCHOOL)FACILITY NUMBER:
380504444
ADMINISTRATOR:ANNA TOBINFACILITY TYPE:
850
ADDRESS:2055 SUNNYDALE AVENUETELEPHONE:
(415) 469-4519
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY:96CENSUS: 34DATE:
04/23/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Anna TobinTIME COMPLETED:
03:15 PM
NARRATIVE
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Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection for an unusual incident report that was submitted to CCL by the facility on 4/5/2024. LPA met with the Site Director, Anna Tobin, and explained the purpose of the inspection to her. The Unusual incident happened on 4/2/2024, relating to a child exiting the classroom alone onto the fenced outdoor play yard after a parent left the gate open at the classroom entrance. The child was found 2 to 5 minutes later while he was riding a bike by the staff.

The facility took a quick response to correct the issue after the incident by keeping the door locked (staff will open the door for whoever needs to enter the room), removing the baby gates at the entrance from each classroom, inspecting the bells on each classroom door to ensure they are in good working condition, the teacher held a group discussion on safety with the children to remind them to stay inside the classroom and not to pass the door & walk out of the classrooms without an adult and reminded parents and guardians to keep the door closed after they enter the classrooms.

LPA inspected the classrooms for health and safety hazards during the inspection.

California Code of Regulations, Title 22 deficiencies are being cited on the following page(s): LIC 809D.

An exit inspection was conducted with the Site Director, Anna Tobin, and appeal rights were explained. A printed copy of the report and the appeal rights were provided to the Licensee at the conclusion of the inspection. Notice of site visit was posted and must remain posted for 30 days for public review.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 04/23/2024 02:50 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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


FACILITY NAME: SFUSD JOHN MCLAREN EARLY ED. SCHOOL (PRESCHOOL)
FACILITY NUMBER: 380504444

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/23/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/24/2024
Section Cited
CCR
101229(a)(1)

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101229 Responsibility for Providing Care and Supervision
(a)(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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The facility took a quick response to correct the issue after the incident by keeping the door locked (staff will open the door for whoever needs to enter the room), removing the baby gates at the entrance from each classroom, inspecting the bells on each classroom door to ensure they are in good working condition,
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This requirement was not met as evidence -based on the unusual incident report submitted by the licensee reporting a child exited the classroom alone onto the fenced outdoor play yard after a parent left the gate open at the classroom entrance. The child was found 2 to 5 minutes later while he was riding a bike by the staff. This poses a potential health risk to children in care.
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the teacher held a group discussion on safety with the children to remind them to stay inside the classroom and not to pass the door & walk out of the classroom without an adult, and reminded parents and guardians to keep the door closed after they enter the classroom. The deficiency was cleared during the inspection.

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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 LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/23/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/23/2024
LIC809 (FAS) - (06/04)
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