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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004176
Report Date: 06/13/2023
Date Signed: 06/13/2023 01:35:38 PM

Document Has Been Signed on 06/13/2023 01:35 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: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: 90CENSUS: 70DATE:
06/13/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:01 PM
MET WITH:Elizabeth Chrisma and Charlotte RiedlerTIME COMPLETED:
01:55 PM
NARRATIVE
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On June 13, 2023 at 12:01 PM, Licensing Program Analyst (LPA) April Cowan conducted an unannounced, case management visit. LPA met with Field Director, Elizabeth Chrisman and Instructional Coach, Charlotte Riedler, and explained the purpose of the visit.

The case management visit is regarding an unusual incident that occurred on 5/10/23. Site director self reported incident to CCLD on May 18, 2023.

On May 10, 2023 at approximately 11:15 AM, a child was found in the hallway unsupervised. Per instructional coach, S1 asked S2 and S3 to watch child while S1 went to the restroom. Child left the room unnoticed. Child walked out of the classroom, down the stairs, and into the lower level hallway. Child was found by another staff member and ultimately Instructional coach who returned child to the class.

Facility has conducted internal investigation. Instructional coach states that after watching the camera recording, the child was unsupervised for two minutes. This is a potential risk to children in care. A type B citation is issued for this deficiency.

On May 24, 2023 facility conducted training on Active Supervision and Transitional Tracking with all staff and required signatures of attendees.
this report was reviewed with the Field Director, Elizabeth Chrisman.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE: DATE: 06/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/13/2023
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 06/13/2023 01:35 PM - It Cannot Be Edited


Created By: April Cowan On 06/13/2023 at 01:15 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: LAUREL HEIGHTS CHILD DEVELOPMENT CENTER(PS)
FACILITY NUMBER: 384004176

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/13/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
06/13/2023
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 5/24/23, Staff conducted training for staff on Active Supervision and Transitional Tracking. Facility has collected signatures of all that attended.
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Based on interviews the licensee did not comply with this regulation in that a child was found by staff unattended in the hallway. This is a potential risk to 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:April Cowan
LICENSING EVALUATOR SIGNATURE:
DATE: 06/13/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/13/2023


LIC809 (FAS) - (06/04)
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