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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504942
Report Date: 07/02/2024
Date Signed: 07/02/2024 01:15:12 PM

Document Has Been Signed on 07/02/2024 01:15 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:ASSOCIATED STUDENTS CHILDREN'S CENTER - PRESCHOOLFACILITY NUMBER:
380504942
ADMINISTRATOR/
DIRECTOR:		ALMAGUER, ERICAFACILITY TYPE:
850
ADDRESS:1650 HOLLOWAY AVENUETELEPHONE:
(415) 338-2403
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94132
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 26DATE:
07/02/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Lorelei BallesterosTIME VISIT/
INSPECTION COMPLETED:
01:30 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
On July 2, 2024, Licensing Program Analysts (LPAs) Van and Leong conducted an unannounced case management and met with the Preschool Assistant Director, Lorelei Y. Ballesteros, to follow up on an unusual incident and discuss preventative measures to ensure the safety and well-being of all children at the Center. Six teachers supervised 26 children.

On June 27, 2024, the facility reported an incident involving children (C1) and (C2) being left unattended in the center's outdoor area. The incident occurred as a group of children transitioned from the outdoor play areas to the classroom during a shelter-in-place drill. The staff did not follow the transitioning protocol, which led to C1 and C2 being unaccounted for and left unattended.

Based on the interview and the incident report received on June 27, 2024, regarding the above incident, supervision was lacking, resulting in two children being left unattended. As a result, the following Title 22 deficiency was cited on the next page.

A notice of site visit was given and must remain posted for 30 days.

Plans of Corrections (POC) were developed and reviewed with the Assistant Director. An exit interview was conducted, and the report and appeal rights were reviewed with the Preschool Assistant Director, Lorelei Y. Ballesteros.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 07/02/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/02/2024
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 07/02/2024 01:15 PM - It Cannot Be Edited


Created By: Brendon Van On 07/02/2024 at 01:00 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: ASSOCIATED STUDENTS CHILDREN'S CENTER - PRESCHOOL
FACILITY NUMBER: 380504942

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/02/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/16/2024
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
101229 Responsibility for Providing Care and Supervision (a)The licensee shall provide care and supervision...children's needs. (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).
1
2
3
4
5
6
7
Immediate action was taken to address this incident. On the same day, the Director conducted a briefing and reviewed active supervision with the staff members involved. As part of the Plan of Correction (POC), the Center will ensure that all staff are trained on supervision, accountability, scanning procedures, and conducting face checks. Training materials and attendance records of staff attending the training will be submitted to LPA by the POC due date.
8
9
10
11
12
13
14
This requirement is not met, as evidenced by the interview and facility incident report. The staff failed to provide adequate supervision, where C1 and C2 were left behind in the center’s outdoor areas during transitioning. This situation poses a potential health and safety risk to children in care.
8
9
10
11
12
13
14
A potential informal meeting is to be scheduled for a later date.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 07/02/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/02/2024


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