414004236-8-5-2021-05-CC-AZEA-C5ZPBG-20210818111017

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 414004236
Report Date: 08/05/2021
Date Signed: 08/05/2021 04:44:22 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
06/14/2021 and conducted by Evaluator Jyoti Saini

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20210614105504

FACILITY NAME:	BUILDING KIDZ (PS)		FACILITY NUMBER:	414004236
ADMINISTRATOR:	NESHEIWAT, SAMANTHA		FACILITY TYPE:	850
ADDRESS:	39 E. 39TH AVENUE		TELEPHONE:	(650) 212-5439
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	70	CENSUS: 24	DATE:	08/05/2021
		UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Site Director Jennifer Nushwat,		TIME COMPLETED:	02:00 PM

ALLEGATION(S):

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Daycare child sustained injuries while in care.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Saini arrived at the facility unannounced to close the complaint investigation into the above allegation and met with Director Jennifer Nushwat. Present in the facility is director, 8 teachers caring for 24 preschoolers. During the course of investigation, LPA Saini conducted interviews, reviewed and obtained pertaining records.

Based on LPA Saini’s interviews and records obtained, it is determined that from 05/03/2021 through 06/11/2021, C1 got a bite multiple times during school hours by another child (C2) leaving a bite marks on C1's arm. The child who had been bitten had his personal rights being violated.

The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Div. 12 & Chapter 3 are being cited on attached 9099-D)The preponderance of evidence standard has been met; therefore, the above allegation is found to be SUBSTANTIATED. California Code of Regulations (Title 22, Div. 12 & Chapter 3 are being cited on attached 9099-D)
This report and rights to comment and appeal have been discussed with Site Director.

Copy of this report was reviewed and will be sent to the director at email address jenniferm@buildingkidz.com by the close of business on 08/05/2021. Confirmation of receipt is required. This report will be kept in the facility file and will be made available for public review upon request.

Any additional questions, call CCLD Office, Monday - Friday, 8am - 5pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

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-20210614105504

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BUILDING KIDZ (PS)	FACILITY NUMBER: 414004236
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/05/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/05/2021 Section Cited HSC 101223(a)(1)	1 2 3 4 5 6 7	101223(a)(1) Personal Rights. (a) The licensee shall ensure that each child is accorded the following personal rights: (1) To be accorded dignity in his/her personal relationships with staff and other persons. This requirement is not met as evidenced by:	1 2 3 4 5 6 7	The Director discussed how the staff can better position themselves in the classroom in order to be able to have better visibility of all the children at all times.The facility has submitted a plan to prevent anymore biting incident. *Deficiency cleared as of today.*
	8 9 10 11 12 13 14	Based on the observation, interview, and record review, LPA confirmed that from 05/03/201 through 06/11/2021, a child(C1) was bitten by another child(C2) several times, while in care which violated the child's personal rights. This poses potential health and safety risk to the 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: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/05/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/05/2021

LIC9099 (FAS) - (06/04)

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