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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002158
Report Date: 04/26/2023
Date Signed: 04/26/2023 01:52:39 PM

Document Has Been Signed on 04/26/2023 01:52 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:BRIGHT HORIZONS UCSF MARILYN REED LUCIA CDCFACILITY NUMBER:
384002158
ADMINISTRATOR:CAYAGO, JENALINEFACILITY TYPE:
830
ADDRESS:610 PARNASSUS AVENUETELEPHONE:
(415) 504-7023
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94143
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 23DATE:
04/26/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Aamena Alloo & Catherine TrabaninoTIME COMPLETED:
11:30 AM
NARRATIVE
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On April 26, 2023, at approximately 9:45am, Licensing Program Analyst (LPA) Ly conducted a Case Management Inspection at the facility due to a self reported incident. During today's visit, LPA met with facility Interim Center Director Aamena Alloo. There were 23 children and 10 staff including the Interim Director present during today's visit. Regional Manager Catherine Trabanino arrived at facility half an hour into the visit.

During today's visit, LPA interviewed Interim Director regarding the self reported Unusual Incident Report happened on 04/19/2023. Based on interview collected during today's visit, self reported phone call to the Regional Office and LIC 624, 3 toddlers were able to open the gate in the yard and walked out of the facility. Children were found by bystander on the sidewalk of the center. Per Interim Director, children were out by the sidewalk for an approximate 3 minutes. Per Interim Director, family of children were notified and informed of the incident. Per Interim Director, facility representatives took immediate action by moving door handle up higher, making it inaccessible to children, every morning before children go out to the yard staff will make sure alarm system is working and training are being conducted with staff regarding care and supervision of children. During today's visit, LPA also confirmed that facility was in ratio when incident happened. Per Interim Director, there were 8 children with 2 staff in the yard when incident happened.

Based on interview and information collected, facility violated the Care and Supervision Regulation. LPA discussed protocols and policies with Interim Director and advised that protocols needs to be put in place at all time to prevent future incidents. Toddler left facility poses an immediate health and safety risk to children in care. Type A deficiency is being cited today in accordance with in accordance with the California Code of Regulations, Title 22, see LIC 809D. Immediate Civil Penalty $500 Assessed on this day. An Informal Office Meeting will be scheduled with the San Bruno Regional Office to discuss the Plan of Corrections facility put in place for the health and safety of the children.

Plans of Corrections (POC) were developed and reviewed with Director. A copy of this report and appeal rights were discussed and left with Director whose signature on this form confirm receipt of reports. Notice of Site Visit was provided to Director. Director was advised Notice of Site Visit to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2023
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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Document Has Been Signed on 04/26/2023 01:52 PM - It Cannot Be Edited


Created By: Winnie Ly On 04/26/2023 at 10:37 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BRIGHT HORIZONS UCSF MARILYN REED LUCIA CDC
FACILITY NUMBER: 384002158

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/26/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/26/2023
Section Cited
CCR
101229(a)(1)

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101229(a)(1) Care and Supervision. No child(ren) shall be left without the supervision, including visual observation, of a teacher at any time except as specified in sections 101216.2(e)(1) and 101230(c)(1).
This requirement was not met as evidence:
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Staff have been reminded to make sure to always maintain sight and sound supervision of children in care.
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Based on self reported LIC 624 dated 04/25/2023 and reported phone call to San Bruno Regional Office on 04/20/2023.
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Facility took immidiate action by moving door handle up to 52 inches from the ground making it inaccessible to toddlers, professonals were called in to check on alarm system, surveillance system, fire inspection was also initiated to make sure all safety changes meet Fire Code and Care of Supervision is being conducted for all staff.

An Office Meeting will be scheduled for later 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.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Winnie Ly
LICENSING EVALUATOR SIGNATURE:
DATE: 04/26/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/26/2023


LIC809 (FAS) - (06/04)
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