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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 210111549
Report Date: 01/29/2024
Date Signed: 01/29/2024 01:29:15 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
01/23/2024 and conducted by Evaluator Hanson Leong
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240123111016
FACILITY NAME:SANTA MARGARITA CHILD CARE CENTERFACILITY NUMBER:
210111549
ADMINISTRATOR:URYU, ARLEENFACILITY TYPE:
850
ADDRESS:1055 LAS OVEJASTELEPHONE:
(415) 499-1277
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY:45CENSUS: 29DATE:
01/29/2024
UNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Claudia Sanchez CadenaTIME COMPLETED:
01:35 PM
ALLEGATION(S):
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- Staff did not provide day care children adequate supervision, resulting in a day care child being bitten.

- Staff did not provide day care children adequate supervision, resulting in a day care child being hit.
INVESTIGATION FINDINGS:
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On 1/29/2024, Licensing Program Analyst (LPA) Hanson Leong made an unannounced complaint visit to the child care center listed above. The purpose of the visit was to deliver the findings and to close out the complaint. The LPA was granted entry by the facility representative, Claudia Sanchez Cadena. The facility representative was informed of the reason for today's visit by the LPA. Present in the center included 7 staff members, and 29 preschool-aged children. All individuals present in the center have received fingerprint clearance to work or be in a childcare center. The center is operating within its capacity and in accordance with the required ratio of staff to children.

All relevant information was gathered and analyzed during the LPA investigation, and all parties involved were contacted and interviewed. Based on information obtained from the LPA investigation, the preponderance of evidence standard has been met. Therefore, the above allegations are found to be substantiated.
See Page 2.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
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 4
Control Number 05-CC-20240123111016
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: SANTA MARGARITA CHILD CARE CENTER
FACILITY NUMBER: 210111549
VISIT DATE: 01/29/2024
NARRATIVE
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Page 2

Please refer to LIC 809D for today's Type B citation.

A copy of today’s report and the facility's appeal rights were given to Claudia Sanchez Cadena. A Notice of Site Visit was given to Claudia Sanchez Cadena and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with Claudia Sanchez Cadena.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 4
Control Number 05-CC-20240123111016
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: SANTA MARGARITA CHILD CARE CENTER
FACILITY NUMBER: 210111549
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/29/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
02/05/2024
Section Cited
CCR
101229(a)(1)
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101229 Responsibility for Providing Care and Supervision
(a) the licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(
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The facility is required to conduct a meeting for all staff members regarding proper supervision in light of a situation where a child was bitten and hit. All staff members are required to sign the attendance sheet for this meeting.
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Supervision shall include visual observation. This requirement is not met as evidenced by:

Based on investigation by the LPA, the licensee did not comply with the section cited above, which poses a potential health and safety risk to children in care.
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 A copy of the meeting must be forwarded to the department to clear up the deficiency.
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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.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 01/29/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/29/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 4