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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213001939
Report Date: 05/10/2024
Date Signed: 05/10/2024 11:53:12 AM

Document Has Been Signed on 05/10/2024 11:53 AM - 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 (PS)FACILITY NUMBER:
213001939
ADMINISTRATOR/
DIRECTOR:		ALIDA LEONFACILITY TYPE:
850
ADDRESS:5520 NAVE DRIVETELEPHONE:
(415) 883-5232
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 46DATE:
05/10/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:14 AM
MET WITH:Alida LeonTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On May 10, 2024, Licensing Program Analyst (LPA) Garcia made an unannounced case management visit to the child day care facility listed above and met with Site Supervisor, Alida Leon. Purpose of the visit was explained to the director. The case management visit is from a self reported incident that occurred on 4/22/2024. The facility had 39 children and 14 teachers supervising the children in three rooms.

The day of the incident, April 22, 2024, the student shared with her mother that teacher from room 8 allegedly put her hand on the child's neck and the mother saw it on the day of, which looked like a finger mark. The parent was not able to get an image of the mark due to the mark fading away towards the end of the day. According to the report, the teacher disclosed to the mother at pick up time that she accidentally stepped on the child's finger but the child complaint that his leg was hurting during the ride home.

LPA Garcia interviewed the 2 staff members from room 8 and the child, regarding the incident. LPA also obtained a copy of the training that the Site Supervisor went over such as personal rights and writing incident reports. According to Alida, the Human Resources are still in the process of investigating the incident and the teacher in question is still on leave. Based on the interviews and documents obtained and conducted by LPA, children's personal rights were not violated.

No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

A copy of this report was given to the Licensee and a site visit notification must be posted for 30 days.
Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview was conducted and report was reviewed with Site Supervisor, Alida Leon.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 05/10/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/10/2024
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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