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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002530
Report Date: 11/02/2023
Date Signed: 11/02/2023 03:17:54 PM


Document Has Been Signed on 11/02/2023 03:17 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:WU YEE CHILDREN'S SERVICES - KIRKWOOD CCC (INF)FACILITY NUMBER:
384002530
ADMINISTRATOR:TAYLOR, RAVELLEFACILITY TYPE:
830
ADDRESS:729 KIRKWOOD AVENUETELEPHONE:
(415) 822-5505
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY:22CENSUS: 20DATE:
11/02/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:04 PM
MET WITH:Joyce YoungTIME COMPLETED:
03:30 PM
NARRATIVE
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On November 2, 2023, Licensing Program Analyst (LPA) Sheran Lo conducted a case management inspection and met with Regional Manager Joyce Young. Purpose of the inspection was explained. Present were Manager, 6 teachers, and 20 in care. The case management was related to the unusual incident reports that was submitted by Regional Manager which occurred at the facility on 10/12/23.

The incident that occurred was where staff witnessed another teacher grabbing child to move to another area which resulted in child crying. Teacher used corporal or unusual punishment. Manager states the teacher was put on leave and then terminated after the full investigation. Half of WuYee staff had training regarding Personal Rights on 10/27/23 and other half is scheduled for training this month.

Discussed during the inspection was to get more information of how the incident happened and what was done to prevent it from happening again. Facility will continue to take this matter seriously.

Exit interview was conducted with Regional Manager Joyce Young. The report and Notice of Site Visit was provided. Notice of Site Visit will be posted for 30 days.


California Code of Regulations, (Title 22, Division 12, Chapter 1), are being cited on the attached LIC 809D
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2023
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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Document Has Been Signed on 11/02/2023 03:17 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: WU YEE CHILDREN'S SERVICES - KIRKWOOD CCC (INF)
FACILITY NUMBER: 384002530

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/02/2023
Section Cited
CCR
101223(1)(a)

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101223 Personal Rights (a) The licensee shall ensure that each child is accorded the following personal rights:(1) To be accorded dignity in her personal relationships with staff. This requirement is not met as evidenced by:
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Facility terminated teacher after investigation with witness and conducted training of Personal Rights for all staff.
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Based on interviews, facility did not ensure child accorded personal rights , which poses a potential Health, Safety, and Personal Rights risk to persons in care.
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Plan of Correction is cleared today from all staff training and provided attendance sheet of training.

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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: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2023
LIC809 (FAS) - (06/04)
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