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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210111538
Report Date: 12/06/2023
Date Signed: 12/06/2023 03:46:02 PM

Document Has Been Signed on 12/06/2023 03:46 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:C.A.M (CFS) HAMILTON (SA)FACILITY NUMBER:
210111538
ADMINISTRATOR:LOMBARDI KELSEYFACILITY TYPE:
840
ADDRESS:5520 NAVE DRIVETELEPHONE:
(415) 883-4385
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY: 47TOTAL ENROLLED CHILDREN: 47CENSUS: DATE:
12/06/2023
TYPE OF VISIT:OfficeUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Alida Leon/Michelle FoxTIME COMPLETED:
03:50 PM
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On December 6, 2023 at 2:00pm, Licensing Program Manager (LPM), Daniel Oquendo, and Licensing Program Analysts (LPAs), Nathan Garcia and Janet Gil, met with site manager, Alida Leon and Assistant Vice President of ECE, Michelle Fox for an informal office meeting.

The purpose of the informal meeting was to discuss the citations issued to the preschool and school age facility.

Citations discussed during this meeting included:
  • Lack of supervision. Facility was cited 10/02/2023 under the preschool license and 11/28/2023 under the school age license for children being left unattended in a classroom, without any staff supervision.
  • Limitations in Capacity. The facility was utilizing a room that is under the preschool license for school age children.

Licensee was reminded:
  • Children must be supervised at all times. No child while present in the facility shall be left unattended by a staff member.
  • The facility must apply for a room change before utilizing a room intended for a different age group.
  • The process of applications must start with the Licensee and the forms will be forwarded to the Fire inspector and they will forward the document back to the agency for denial or approval.

During meeting, LPM provided licensee with:
  • Supervision regulations
  • Process for increasing or decreasing capacity in a childcare center and plans to proceed with the application.

To correct citations issued, licensee plans:
  • The facility implemented training for all staff members and verified it to LPA by sending a list of employees who attended.
  • 2 staff members were put on administrative leave due to this incident. Per their policy, that is their first and final notice.
  • The facility plans to proceed with the decrease capacity in preschool license #213001939 by removing room 5 and increase the capacity in school age license #210111538 and add room 5.

Exit interview conducted and report was reviewed with site manager, Alida Leon and Assistant Vice President of ECE, Michelle Fox.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 12/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/06/2023
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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