414001867-5-9-2023-05-CC-GLEG-CS3TMP-20230522145124

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414001867
Report Date: 05/09/2023
Date Signed: 05/09/2023 12:11:48 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
04/20/2023 and conducted by Evaluator Catrina Quimbo

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20230420102847

FACILITY NAME:	HUGS HANGOUT		FACILITY NUMBER:	414001867
ADMINISTRATOR:	PAM COHN		FACILITY TYPE:	850
ADDRESS:	500 ACACIA AVENUE, ROOM # PC-1		TELEPHONE:	(650) 465-7529
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	69	CENSUS: 48	DATE:	05/09/2023
		UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Pam Cohn		TIME COMPLETED:	12:30 PM

ALLEGATION(S):

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Uncleared adult(s) are providing care and supervision to day care children.

INVESTIGATION FINDINGS:

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On May 9, 2023 at approximately 11:00am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, complaint visit to Hugs Hangout. LPA met with licensee, Pam Cohn, and explained the purpose of the visit.

Present during LPA's visit included 7 staff members (including licensee) and 48 enrolled preschool children. Facility currently operates in 3 classrooms: Bears (PC1), Tigers (7-H) and Monkeys (1-H).

During investigation, LPA conducted classroom observations, reviewed documents obtained, and interviewed licensee. During interview with licensee, licensee stated at least 1 adult (A1) worked in the preschool classroom with children present during week of 4/17/2023. Per staff roster, A1 received fingerprint clearance 4/22/2023. A1 was present in the classroom prior to receiving fingerprint clearance.

Based on LPA's observations, interview and record review which were conducted, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED.
(Continue on 9099C)

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

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 3

Control Number 05-CC-20230420102847

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: HUGS HANGOUT	FACILITY NUMBER: 414001867
	VISIT DATE: 05/09/2023

NARRATIVE

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(Continued, Page 2...)
California Code of Regulations, Title 22, Division 12, are being cited. Please refer to 9099D for more information.

LPA observed A1 to have fingerprint clearance as of 04/22/2023. Deficiency cited on this date has been cleared as of this date.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Licensee was also provided copy of Appeal Rights and POC letter.

Exit interview conducted and report was reviewed with licensee, Pam Cohn.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC9099 (FAS) - (06/04)

Page: 2 of 3

Control Number 05-CC-20230420102847

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: HUGS HANGOUT	FACILITY NUMBER: 414001867
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/09/2023

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/09/2023 Section Cited CCR 102370(d)(1)	1 2 3 4 5 6 7	102370 Criminal Record Clearance (d)(1) All individuals subject to a criminal record review... shall prior to working... in a licensed facility: (1) Obtain a California clearance or a criminal record exemption as required by the Department. This requirement was not met as evidenced by:	1 2 3 4 5 6 7	A1 went through fingerprinting process and received fingerprint clearance as of 4/22/2023.
	8 9 10 11 12 13 14	Based on record review and interview, A1, an uncleared adult was working in the preschool classroom with preschool children week of 4/17/2023. This poses a potential Health and Safety risk to persons in care.	8 9 10 11 12 13 14
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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 Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023

LIC9099 (FAS) - (06/04)

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