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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001492
Report Date: 08/08/2023
Date Signed: 08/08/2023 05:36:00 PM

Document Has Been Signed on 08/08/2023 05:36 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SHORES CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414001492
ADMINISTRATOR:BECKER, LISAFACILITY TYPE:
850
ADDRESS:1050 TWIN DOLPHIN DRIVETELEPHONE:
(650) 594-1100
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 158TOTAL ENROLLED CHILDREN: 158CENSUS: 80DATE:
08/08/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:45 PM
MET WITH:Lisa Becker TIME COMPLETED:
04:45 PM
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On 8/8/2023 at 2:45PM. Licensing Program Analyst, (LPA) Luis J. Gomez met with Director, Lisa Becker. The purpose of today's inspection was explained and is in response to an incident, occurring on 7/28/2023. Incident was self- reported by facility management. Present during inspection was the director and 14 staff supervising 80 children. LPA inspected facility, indoors and outdoors, for health and safety hazards.

During the inspection, LPA performed site observations, record review, and interviews.

An unusual incident reported was received by the Department on 8/3/2023. Report stated, that during an altercation between children, C1, C2, classroom staff, S1, was observed using an inappropriate intervention method while assisting day-care child. Per director, this incident initiated a subsequent investigation, and authorized representatives of both children were informed. Per Director, staff S1, has continuously denied the allegations, stating respectful intervention is always used when assisting children with behavioral needs. Per director, staff are required to provide children with positive verbal redirection, and preferred activity options at all times.

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Chapt. 1. ***

This report and rights to comment were discussed with Director. This report must be available in the facility for public review. Notice of site inspection was posted. Any additional questions to call Office, M-F, 8a-5p, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
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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