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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004009
Report Date: 07/01/2024
Date Signed: 07/01/2024 05:47:15 PM

Document Has Been Signed on 07/01/2024 05:47 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:MEANINGFUL BEGINNINGS LLCFACILITY NUMBER:
384004009
ADMINISTRATOR/
DIRECTOR:		OZUNA, YARENAFACILITY TYPE:
830
ADDRESS:633 TARAVAL STREETTELEPHONE:
(415) 941-7965
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: 12DATE:
07/01/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:10 PM
MET WITH:Amany Salah, Luisa Baj, and Ashley DuTIME VISIT/
INSPECTION COMPLETED:
05:45 PM
NARRATIVE
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On July 1, 2024., Licensing Program Analyst (LPA) Van conducted an unannounced Case Management inspection in response to an incident that occurred at the facility on June 28, 2024 which the center sent the written report to the Licensing Office general mailbox at 4:20 pm the same day. LPA met with the new site Director, Amany Salah, and Executive Director, Luisa Baj. The purpose of the inspection was explained, and entry to the Center was granted. Today, six staff members supervised 12 children (4 infants and eight toddlers.) The owner, Ashley Du, arrived during the visit.

According to the incident report, child C1 had an allergic reaction after consuming dairy products. The staff at the center gave C1 pizza that contained cheese. Per the incident report, C1 was crying for 5-10 minutes; when the staff checked on C1, they noticed that C1 had developed bumps on the body. The staff then administered Benadryl, but C1 ended up vomiting. C1's mother was contacted and quickly arrived at the center. While on the phone with a medical professional, C1's mother administered an EpiPen. C1 was taken to the emergency room soon after.

After interviewing the director, executive director, and center owner and reviewing the incident report submitted to the licensing office, it was determined that a violation of the regulations occurred when staff mistakenly served food to C1 that they were allergic to. Furthermore, upon admission to the facility, C1’s family informed the center that C1 had a dairy allergy; this information was confirmed by reviewing C1’s file during the visit.

As a result, a type A deficiency is cited on LIC 809D. The center is informed to provide a copy of the Evaluation Report and the Type “A” Deficiency cited to the parents and guardians of children currently enrolled in care and parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report and appeal rights were reviewed with the new Director, Amany Salah.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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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Document Has Been Signed on 07/01/2024 05:47 PM - It Cannot Be Edited


Created By: Brendon Van On 07/01/2024 at 03:52 PM
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: MEANINGFUL BEGINNINGS LLC
FACILITY NUMBER: 384004009

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/02/2024
Section Cited
CCR
101227(a)(7)(B)

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101227 Food Services (a) In child care centers providing meals to children, the following shall apply: (7) Modified diets prescribed by a child's physician as a medical necessity shall be provided. (B) A child shall not be served any food to which the child's record indicates he/she has an allergy.
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The director is required to submit a written Plan of Correction (POC) outlining how to ensure that children are provided with safe and healthy accommodations. The POC must detail how the process will be supervised to correct any issues and prevent them from happening again. This should involve retraining staff on feeding and meal preparation protocols, as well as creating individual action plans, particularly for children with food allergies. Furthermore, it should outline how all staff members will be made aware of children with food allergies.
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Based on the interview and records review, the center did not comply with the section cited above. Specifically, dairy products were given to child C1 by mistake, despite the family previously disclosing to the center upon admission that C1 should not have dairy products. This situation presents an immediate health safety risk to the children in care.
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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:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 07/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/01/2024


LIC809 (FAS) - (06/04)
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