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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000931
Report Date: 10/19/2023
Date Signed: 10/19/2023 02:54:44 PM


Document Has Been Signed on 10/19/2023 02:54 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:IHSD, INC-SOUTH SAN FRANCISCO HEAD START CENTERFACILITY NUMBER:
414000931
ADMINISTRATOR:YESSENIA FLORES-GUZMANFACILITY TYPE:
850
ADDRESS:825 SOUTHWOOD DRIVETELEPHONE:
(650) 368-1728
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:80CENSUS: 30DATE:
10/19/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:05 PM
MET WITH:Youly EngTIME COMPLETED:
03:10 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this case management visit. Purpose of the visit is due to an unusual incident reported to licensing. On 10/6/2023, a child (C1) was momentarily outside the classroom during a transition time. LPA gathered information and interviewed staff. The child is in room #1. The classroom door was open due to another guardian picking up their child. Somehow, C1 was able to exit the classroom unnoticed by teachers in room #1. Staff say they have an internal policy that anytime a door is opened, or staff leave the classroom, a children's head count is immediately done. On the day of incident, there were eight children in the classroom; one child was being picked up, so there should have been seven children remaining. However when teachers took count, they counted only six children and immediately started to figure out who was missing. C1 was found directly adjacent to the classroom in the front corridor area. Another teacher (S3) who works in a different classroom (#3) saw C1 the entire time C1 was outside and was guessing the child was being picked up. By that time, about 20-30 seconds had passed, and teachers in room #1 opened their door and retrieved C1 back in the classroom. At no time had C1 not been in the line of site of a teacher. Since this incident, the facility has conducted all staff training on supervision, and considering additional options to monitor and supervise children to try to prevent future incidents. Some of the ideas were to put a latch or baby gate outside the classroom door for when then the door is opened for parent/guardian pick up of a child. No violation of licensing regulations occurred since child had been visually in line of sight of a teacher during the incident.

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

Notice of site visit provided and must remain posted for 30 days.
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/19/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/19/2023
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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