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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504793
Report Date: 04/16/2024
Date Signed: 04/16/2024 12:49:55 PM

Document Has Been Signed on 04/16/2024 12:49 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:TELEGRAPH HILL NEIGHBORHOOD CENTER(PS)FACILITY NUMBER:
380504793
ADMINISTRATOR/
DIRECTOR:		LUU, CONNIEFACILITY TYPE:
850
ADDRESS:660 LOMBARD STREETTELEPHONE:
(415) 421-6443
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94133
CAPACITY: 87TOTAL ENROLLED CHILDREN: 87CENSUS: 86DATE:
04/16/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Sara DixonTIME VISIT/
INSPECTION COMPLETED:
01:00 PM
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On April 16, 2024 at approximately 12:30pm, Licensing Program Analyst (LPA) Ly conducted a Plan of Correction Visit for a self reported incident taken place in the facility's gymnasium. LPA met with Site Supervisor, Sara Dixon and Director Connie Luu during the visit. Purpose of the inspection was explained. There are 86 children in attendance today with the present of 24 staff .

A Type B deficiency was cited on 03/26/2024 regarding a self reported incident is cleared during today's visit.

A copy of this report and was discussed and left with Facility Representatives whose signature on this form confirmed receipt of the report. A Letter of Deficiency Citation Clear is also being provided to the Site Supervisor.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
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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