<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003047
Report Date: 03/26/2024
Date Signed: 03/26/2024 12:50:59 PM

Document Has Been Signed on 03/26/2024 12:50 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:UNIVERSITY CHILD CARE AT MISSION BAY (PS)FACILITY NUMBER:
384003047
ADMINISTRATOR:CAHILL, MEGANFACILITY TYPE:
850
ADDRESS:727 NELSON RISING LANETELEPHONE:
(617) 673-8000
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94158
CAPACITY: 206TOTAL ENROLLED CHILDREN: 288CENSUS: 235DATE:
03/26/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
08:21 AM
MET WITH:Director Megan Cahill /Executive Director Sandra HilliardTIME COMPLETED:
01:00 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
C1 = Child 1

On March 26, 2024 at approximately 8.20 AM, Licensing Program Analyst (LPA) Tso conducted an unannounced, case management visit. LPA met with Director, Megan Cahill, and explained the purpose of the visit. Present in the facility is directors, 56 staff, and 235 children in care.

The case management visit is regarding an unusual incident that occurred on March 6, 2024. Facility self-reported incident to CCLD on March 13, 2024.

On March 6, 2024, when the preschool class was transitioning from the playground to the classroom, C1 was left on the deck. Although a name-to-face conducted before leaving the deck, a sweep was not conducted by the staff and C1 remained on the deck when the class went into the classroom and closed the door. A kitchen staff was on the deck to collect food bins of classrooms, observed C1, and reconnected C1 with the classroom and engaged with C1 class.

Per the statements of the involved teachers and the kitchen staff (LPA also interviewed to the kitchen staff) taken by the facility, the child was alone and not supervised by a teacher for about 30 seconds before the kitchen staff took the child back to the class. This posed a potential risk to the health, safety or personal rights risks to the person in care. Type B citation is issued for this deficiency this day. (See LIC809 D)

An exit interview was conducted with the Executive Director, Sandra Hilliard, and a plan of correction was discussed. A copy of this report with the appeal rights was discussed and provided, and the signature of this form acknowledges the receipt of these documents. A notice of site visit was given to the Director and must remain posted for 30 days.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 03/26/2024 12:50 PM - It Cannot Be Edited


Created By: Man Tso On 03/26/2024 at 11:00 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: UNIVERSITY CHILD CARE AT MISSION BAY (PS)
FACILITY NUMBER: 384003047

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/26/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/09/2024
Section Cited
CCR
101229(a)(1)

1
2
3
4
5
6
7
101229 Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The Director should train staff on proper supervision and email LPA agenda and a signature of all in attendance by 4/9/2024.
8
9
10
11
12
13
14
Based on interview, statements provided by the facility, and Incident report, staff left a child alone without supervision on a deck for at least 30 seconds, which poses/posed a potential risk to health, safety or personal rights risk to persons 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:Garfield Leung
LICENSING EVALUATOR NAME:Man Tso
LICENSING EVALUATOR SIGNATURE:
DATE: 03/26/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/26/2024


LIC809 (FAS) - (06/04)
Page: 2 of 2