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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 380504578
Report Date: 09/18/2024
Date Signed: 09/18/2024 02:41:45 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
09/03/2024 and conducted by Evaluator Brendon Van
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20240903105252
FACILITY NAME:YMCA OF SF., RICHMOND BRANCH, LAFAYETTE SITEFACILITY NUMBER:
380504578
ADMINISTRATOR:JAZZY MENDOZAFACILITY TYPE:
840
ADDRESS:4545 ANZA STREETTELEPHONE:
(415) 916-6580
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY:200CENSUS: 66DATE:
09/18/2024
UNANNOUNCEDTIME BEGAN:
01:25 PM
MET WITH:Jazzy MendozaTIME COMPLETED:
03:00 PM
ALLEGATION(S):
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-Staff are operating beyond the terms and conditions of the license
INVESTIGATION FINDINGS:
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On September 18, 2024, Licensing program analyst (LPA) Van conducted a subsequent complaint inspection visit to deliver findings on the above allegation. LPA met with the Site Coordinator, Alicia Brannan. The purpose of the inspection was explained to the Coordinator, and access to the center was granted. Eight staff members supervised 66 school-age children (three of the staff members were from the childcare career staffing). During the inspection, the Site Director, Jazzy Mendoza, arrived.

After a thorough investigation, including interviews with staff, classroom observations, and reviews of all relevant documents, it was found that the required ratio of one teacher to 14 school-age children was not being met. During the initial September 5, 2024 inspection, LPA observed one teacher supervising 15 children engaged in different activities. Interviews further confirmed that it was common for teachers to supervise more than 14 children, thus not meeting the required ratio. As a result, the preponderance of evidence standard has been met. Therefore, the above allegation is found to be SUBSTANTIATED.
Continued on page 2...

Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
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 3
Control Number 05-CC-20240903105252
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: YMCA OF SF., RICHMOND BRANCH, LAFAYETTE SITE
FACILITY NUMBER: 380504578
VISIT DATE: 09/18/2024
NARRATIVE
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See LIC 9099D for the type A deficiency cited today on the following page.
LPA informed the Director and Coordinator to provide a copy of this licensing report documenting the Type A citation to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of the Licensing Report (LIC 9224) or other written statement must be placed in the child's file for verification.

An exit interview was conducted, and the report was reviewed with the Site Coordinator, Alicia Brannan, and Site Director, Jazzy Mendoza.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20240903105252
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: YMCA OF SF., RICHMOND BRANCH, LAFAYETTE SITE
FACILITY NUMBER: 380504578
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/18/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
09/19/2024
Section Cited
CCR
101516.5(b)(1)
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101516.5 Teacher-Child Ratio (b) There shall be a staffing ratio of one teacher and one aide present to every 28 children in attendance. (1)A teacher shall supervise no more than 14 children or with an aide a maximum of 28 children.

This requirement was not met as evidenced by:
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The facility is required to maintain a staff-to-children ratio of one teacher for every 14 school-age children present. Furthermore, the Center must provide an updated personnel report (LIC 500) and a revised staff schedule that includes the allocated breaks, lunch hours, and daily and weekly shift times for qualified teachers and aides by the deadline of 9/19/2024. These corrective actions are crucial to ensure compliance with the required staff-to-children ratios and the safety of the children in care.


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Based on observations and interviews, the center did not comply with the abovementioned regulations. LPA confirmed that the facility is not operating at the required teacher-to-school-age ratio of 1:14. This poses an immediate health and safety risk to children in care.
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The director stated she would submit proof of correction to LPA by the due date.
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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: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 09/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2024
LIC9099 (FAS) - (06/04)
Page: 3 of 3