410500286-2-24-2023-05-CC-DJOO-CPWPPM-20230314112946

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 410500286
Report Date: 02/24/2023
Date Signed: 02/24/2023 04:33:37 PM

Substantiated

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
12/21/2022 and conducted by Evaluator Andrea Medlin

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20221221112806

FACILITY NAME:	HAPPY HALL SCHOOL		FACILITY NUMBER:	410500286
ADMINISTRATOR:	MARQUEZ, MICHELLE		FACILITY TYPE:	850
ADDRESS:	233 SANTA INEZ AVENUE		TELEPHONE:	(650) 583-7370
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	143	CENSUS:	DATE:	02/24/2023
		UNANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Michelle Marquez		TIME COMPLETED:	04:30 PM

ALLEGATION(S):

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LACK OF SUPERVISION: Daycare child wandered outside of facility.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this conclusionary complaint visit. Purpose of the visit explained. Additional information and interviews have been conducted. LPA attempted to interview child involved in incident but was unable to get any information. LPA also interviewed several staff persons. Based on information gathered, a child (C1) was able to exit the outdoor area through two gates and ended up on the oustide of the front of school. Information obtained revelaed that child was there unsupervised for unknown amount of time and another guardian (who was picking up a different child) saw C1 outside alone and brought child back into facility through one of the gates. Information relayed to licensing is that a staff person (later identified as S1) came to the gated area to retrieve child and brought child back into play area. The incident had not been reported to director until the following day by another staff person (S2) who relayed that he was made aware of the incident from a parent.

(Continued on next page 9099-C and 9099-D)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 05-CC-20221221112806

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: HAPPY HALL SCHOOL	FACILITY NUMBER: 410500286
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/24/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type A 02/27/2023 Section Cited CCR 101229(a)(1)	1 2 3 4 5 6 7	Responsibility for Providing Care and Supervision: 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.	1 2 3 4 5 6 7	Facility to come up with a plan regarding supervision of children at all times. Facility has provied an all staff training to staff after this incident on supervision issues.Copy obtained during the visit. Deficiency cleared during the visit.
	8 9 10 11 12 13 14	This requirement is not met based on information that a child (C1) was able to exit facility and found first by a legal guardian of another child, and then subsequently a staff person. This poses an immediate health and safety risk to children in care.	8 9 10 11 12 13 14
	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: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

LIC9099 (FAS) - (06/04)

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Control Number 05-CC-20221221112806

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: HAPPY HALL SCHOOL	FACILITY NUMBER: 410500286
	VISIT DATE: 02/24/2023

NARRATIVE

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Since all child care children are required to be visually supervised at all times, there was found to be a time, however brief, that child was unsupervised by making it outside the facility without a staff person.

The deficiencies cited on the following pages are in violation of the California Code of Regulations, Title 22, Division 12, Chapter 1.

This report is reviewed with facility representative and a copy of this report must be made available for public review upon request.

Due to Type A violations, this report and violations must be given to all current parents/guardians and newly enrolled families for the next 12 months and documented on the LIC 9224 and returned to each child's file.

Notice of site visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/24/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2023

LIC9099 (FAS) - (06/04)

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