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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002202
Report Date: 09/02/2026
Date Signed: 09/02/2026 03:08:36 PM

Document Has Been Signed on 09/02/2026 03:08 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:FACESSF - HAYES VALLEY CDC (INFANT)FACILITY NUMBER:
384002202
ADMINISTRATOR/
DIRECTOR:		STEPHANIE KUYPERFACILITY TYPE:
830
ADDRESS:305 BUCHANAN STREETTELEPHONE:
(415) 552-1535
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY: 18TOTAL ENROLLED CHILDREN: 12CENSUS: 0DATE:
09/02/2026
TYPE OF VISIT:OfficeANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
02:00 PM
MET WITH:Stephanie Kuyper (S1) and Alysia Gonzales (S2)TIME VISIT/
INSPECTION COMPLETED:
03:20 PM
NARRATIVE
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On September 2, 2026, Licensing Program Analyst (LPA) Leong and Licensing Program Manager (LPM) Leung met with Director Stephanie Kuyper and Senior Director of Child Development Alysia Gonzales at the San Bruno Regional Office for a scheduled office meeting.

On July 30, 2026, the facility self-reported an incident in which a child left the facility without on-site staff's knowledge. According to the Unusual Incident Report, a staff member left the half-door open to transport the children's blankets to the cots, and the child passed through the half-door and pushed the door open. The child then exited the facility for approximately 4 minutes before a passerby escorted the child back.

Following the incident on July 30, 2026, the facility was issued a Type Absence of Supervision deficiency on August 7, 2026. The facility was issued a $1000 civil penalty for this incident

According to S1 and S2, a siren has been installed as a safety precaution on the half door.

On February 17, 2026, during lunch, a staff member observed that a child repeatedly stood from the table. A staff member pulled the back of the child’s sweatshirt, preventing the child from standing. When the child removed the sweatshirt and stood again, the staff member pulled the child’s arm and guided the child back to the chair. The staff member then sat beside the child to block the child from leaving the table.

Following the incident on February 17, 2026, the facility was issued a Type B personal rights deficiency on March 5, 2026, for restraining the child.

See Page 2

Garfield Leung
Hanson Leong
DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/02/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: FACESSF - HAYES VALLEY CDC (INFANT)
FACILITY NUMBER: 384002202
VISIT DATE: 09/02/2026
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According to S1, she went over the training on personal rights with the staff, which was completed on March 27, 2026

On October 10, 2025, a child fell, resulting in a head injury. Staff were not aware of the seriousness of the injury, and the authorized representative of the child was not notified.

Following the October 10, 2025, incident, the facility received a Type B lack of supervision deficiency on October 22, 2025.

This deficiency was previously cleared.

Staff members directly involved in the incidents listed above are no longer associated with the facility. .

The facility has submitted Plan of Correction (POC) documents for both deficiencies from March 5, 2026, and August 7, 2026

Based on the information provided by the facility, the deficiencies cited on March 5, 2026, and August 7, 2026, will be cleared as of today.

The facility will be subject to required annual visits going forward.

Exit interview conducted and report was reviewed with the facility representatives, Stephanie Kuyper and Alysia Gonzales.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Hanson Leong
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/02/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/02/2026
LIC809 (FAS) - (06/04)
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