<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504783
Report Date: 04/12/2022
Date Signed: 04/12/2022 12:42:05 PM


Document Has Been Signed on 04/12/2022 12:42 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:LAUREL HILL NURSERY SCHOOLFACILITY NUMBER:
380504783
ADMINISTRATOR:CHEW, MARIAFACILITY TYPE:
850
ADDRESS:401 EUCLID AVENUETELEPHONE:
(415) 751-8784
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:59CENSUS: 32DATE:
04/12/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:50 AM
MET WITH:Maria ChewTIME COMPLETED:
12:55 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
Licensing Program Analyst (LPA) Mok conducted an unannounced case management inspection for an unusual incident that was reported by the facility in March, 2022. LPA met with the Site Director, Maria Chew,. The purpose of the inspection was explained to her. There were 32 children with 4 teachers, 3 working parents and 1 Site Director present. The unusual incident was related to 2 daycare children. LPA interviewed the staff during the inspection. LPA also obtained a copy of the children's roster from the facility during the inspection. LPA needs to conduct further investigation on the incident.















This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For quarterly update on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/12/2022
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 1