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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004176
Report Date: 07/14/2023
Date Signed: 07/14/2023 11:40:18 AM

Document Has Been Signed on 07/14/2023 11:40 AM - 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:LAUREL HEIGHTS CHILD DEVELOPMENT CENTER(PS)FACILITY NUMBER:
384004176
ADMINISTRATOR:KRISTINA LANGNERFACILITY TYPE:
850
ADDRESS:2675 GEARY BLVD. SUITE 400TELEPHONE:
(415) 490-5204
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 110TOTAL ENROLLED CHILDREN: 88CENSUS: 48DATE:
07/14/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Kristina LangnerTIME COMPLETED:
11:55 AM
NARRATIVE
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On July 14, 2023 at 9:25 AM, Licensing Program Analyst (LPA) Cowan conducted an unannounced, Case Management visit. LPA met with site director, Kristina Langner, and explained the purpose of the visit. Present in the facility is director, 13 staff, and 48 children in care.
The case management visit is regarding an Unusual Incident that occurred on June 21, 2023. Site director self reported incident to CCLD on June 29, 2023.

On June 21, 2023, during drop off hours, child was dropped off to the facility. T1 and T2 was present and transitioning class to the play yard. Per site director, as class was transitioning to the play yard, and child was not properly checked in by staff. Director states that T2 did a sweep of the classroom before exiting the classroom, and director states that T2 did not observed any children. Per director, child has a history of hiding, and child hid from T2's view. The incident report states that child was left alone in the classroom for 19 to 20 minutes. This is an immediate risk to children in care. A Type A citation is issued this day for this deficiency.
Director states that staff later realized that child was not present in the yard, and T1 went to the classroom to retrieve child. Per director, child was found playing in the play area of the classroom, and child was fine.

Director states that child's parents were informed of incident the same day. Facility did investigate incident and reprimanded supervising staff. Director states that all staff have participated in training conducted by facility's Regional Manager. Director states that moving forward, transitions will have to slow down and wait so that all children may be properly checked in. Also, all classes must transition through the lobby area so that staff may confirm the number of children present and checked in.

Exit interview conducted and report was reviewed with the site director, Kristina Langner.

> See next page for citation.

* T1 = Teacher 1, T2 = Teacher 2

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE: DATE: 07/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/14/2023
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 07/14/2023 11:40 AM - It Cannot Be Edited


Created By: April Cowan On 07/14/2023 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: LAUREL HEIGHTS CHILD DEVELOPMENT CENTER(PS)
FACILITY NUMBER: 384004176

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/14/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
07/28/2023
Section Cited
CCR
101229(a)(1)

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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:
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On 7/12/23, Facility's Regional Manager came to train staff on proper supervision of children. Facility must have parents read report and collect receipt of report by 7/28/23.
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Based on interview and incident report, licensee did not comply with this regulation. Child was left alone in the classroom for 19 to 20 minutes without teacher supervision.
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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:April Cowan
LICENSING EVALUATOR SIGNATURE:
DATE: 07/14/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/14/2023


LIC809 (FAS) - (06/04)
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