384001720-8-27-2019-05-CC-AMAG-BFY25Q-20190912170554

Community Care Licensing

COMPLAINT INVESTIGATION REPORT

Facility Number: 384001720
Report Date: 08/27/2019
Date Signed: 08/27/2019 11:56:04 AM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 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
08/22/2019 and conducted by Evaluator Luis Gomez

PUBLIC

COMPLAINT CONTROL NUMBER: 05-CC-20190822125801

FACILITY NAME:	KIDS BY THE BAY - PRESCHOOL		FACILITY NUMBER:	384001720
ADMINISTRATOR:	WESTMORELAND, ROCHELLE		FACILITY TYPE:	850
ADDRESS:	90 SEVENTH STREET		TELEPHONE:	(415) 554-8100
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY:	78	CENSUS: 31	DATE:	08/27/2019
		UNANNOUNCED	TIME BEGAN:	08:55 AM
MET WITH:	Director, Mandy Hernandez		TIME COMPLETED:	12:00 PM

ALLEGATION(S):

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Record Keeping: Facility is not properly maintaining children immunization's records.

INVESTIGATION FINDINGS:

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Licensing Program Analyst (LPA) Luis J. Gomez met with director, Mandy Hernandez for this complaint visit. The purpose of the visit was explained. Present today is the director and 8 staff supervising 31 PreK children.

During the course of the investigation, LPA Gomez reviewed a sample of the facility's children's files, Interviewed the site director and reviewed the facility family handbook. Based on a file review, LPA Gomez observed that a child's immunization records have not been properly updated. Based on a file review, the preponderance of evidence standard has been met, therefore the above allegations are found to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division 12, Chapter 1), are being cited on the attached LIC 9099D.

An exit interview was conducted and a copy of this report and rights to appeal were reviewed and provided to staff. Notice of Site Visit was observed to be posted.

Substantiated

Estimated Days of Completion:

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC9099 (FAS) - (06/04)

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Control Number 05-CC-20190822125801

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KIDS BY THE BAY - PRESCHOOL	FACILITY NUMBER: 384001720
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/27/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 08/30/2019 Section Cited CCR 101220.1(g)(1)	1 2 3 4 5 6 7	101220.1(g)(1) Immunization's. ...This requirement includes updating each child's immunization record when the child is due to receive required immunization after enrollment in the child care center... This requirement is not met as evidenced by	1 2 3 4 5 6 7	Director stated she will provide notice to parent's reminding them to submit updated children's immunization records and submit a copy of this notice to LPA Gomez by the due date: 09/06/2019 Director will submit proof of correction to LPA Gomez via email.
	8 9 10 11 12 13 14	Based on a file review, LPA Gomez confirmed that of the sample reviewed, one of children's immunization records have not been properly updated. This is a potential health and safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2019

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2019

LIC9099 (FAS) - (06/04)

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