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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213002658
Report Date: 11/08/2023
Date Signed: 11/08/2023 12:14:40 PM

Document Has Been Signed on 11/08/2023 12:14 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 (INF)FACILITY NUMBER:
213002658
ADMINISTRATOR:LOMBARDI KELSEYFACILITY TYPE:
830
ADDRESS:5520 NAVE DRIVETELEPHONE:
(415) 883-5318
CITY:NOVATOSTATE: CAZIP CODE:
94949
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 24DATE:
11/08/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:37 AM
MET WITH:Alida Leon/Buntawan VamnutjindTIME COMPLETED:
12:30 PM
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On November 8, 2023 Licensing Program Analyst (LPA) Garcia made an unannounced case management visit to the child day care facility listed above and met with Director, Buntawan Vamnutjinda. Purpose of the visit was explained to the director. The case management visit is from a self reported incident that occurred on 10/30/2023.
The facility had 24 children and 11 teachers in total on site.

According to the director, Buntawan Vamnutjind and Family Advocate, Soraya Rabanales, the mother of the 2 year old child reported to them that she noticed marks or bruises near the child's thigh area. The child was gesturing and pointing while saying the name of the teacher "Maira, like this" (in Spanish), while she was changing her diaper. The mother then sent the pictures on 10/12/23 to teacher Maira and she replied to her "I'll check with in with you." According to the staff, there was no evidence that those marks were done during the diaper change at school. The director also shared that the teachers do group diaper changing and the changing table is in front of the classroom. The possibility of a child being harmed during diaper changing is unlikely because there are always other teachers around. The mother of the child, director and family advocate had a meeting and the mother requested to have another teacher in the classroom for her daughter as the main teacher. The director replied that they will still be in the same classroom and the teacher she requested already had 4 children and was given another choice to move to another classroom but the mother declined. The director did an observation of room 9 and found no evidence or indication that the children are scared of the teachers. The staff also saw that the children have good relationships with all the teachers. The child still attends the same classroom with the same teachers, and they also have not heard of anything from the mother about unusual marks.

LPA Garcia interviewed the staff members and the teacher from room 9 regarding the incident. The director also did an observation in the classroom to see the interaction of the child and staff and other teachers in the classroom and shared such allegations did not happen. Based on the interviews conducted by LPA, child'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 Director, Buntawan Vamnutjinda.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/08/2023
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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