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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 384002478
Report Date: 10/28/2021
Date Signed: 10/28/2021 01:50:08 PM



STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
10/19/2021 and conducted by Evaluator April Cowan
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20211019095623
FACILITY NAME:BRIGHT HORIZONS AT KANSAS STREET (INF)FACILITY NUMBER:
384002478
ADMINISTRATOR:DAHIYA, LAURENFACILITY TYPE:
830
ADDRESS:200 KANSAS STREET, STE. 100TELEPHONE:
(415) 863-2533
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94103
CAPACITY:64CENSUS: 33DATE:
10/28/2021
UNANNOUNCEDTIME BEGAN:
01:15 PM
MET WITH:Aerie KimTIME COMPLETED:
02:05 PM
ALLEGATION(S):
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Facility is operating out of ratio
INVESTIGATION FINDINGS:
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On 10/28/21 at 1:15 PM, Licensing Program Analyst (LPA) Cowan met with assistanr site director, Aerie Kim, for an unannounced subsequent complaint inspection. The purpose of inspection was explained. Present in the facility are assistant site director and 13 staff caring for 33 children. Thirteen children were napping.
In today’s inspection, LPA along with assistant site director inspected for health and safety hazards. LPA observed no deficiencies during inspection.

During the course of investigation, interviews were conducted with site director, staff, and parents. Through interviews, it has been found that on 10-15-21, a teacher supervised five infants while on the school yard in the morning. When the teacher realized that she was out of ratio, she called for more staff. The teacher was alone for about five minutes before other staff arrived to help supervise children.

Based on LPA’s observation and interviews which were conducted and record review(s), the preponderance of evidence standard has been met, therefore the above allegation(s) is founded to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
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 05-CC-20211019095623
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BRIGHT HORIZONS AT KANSAS STREET (INF)
FACILITY NUMBER: 384002478
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/28/2021
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/05/2021
Section Cited
CCR
101416.5(b)
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101416.5 Staff-Infant Ratio
(b) There shall be a ratio of one teacher for every four infants in attendance. This requirement was not met as evidenced by:
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Director agrees to submit to LPA a plan for a faster response along with a description scheduling that would support this plan by 11/5/21.
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Based on interview, a teacher was present with 5 infants for about five minutes before another staff came to help on 10-15-21. This is a potential risk for children in care.
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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: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/28/2021
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021
LIC9099 (FAS) - (06/04)
Page: 2 of 2