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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004459
Report Date: 11/20/2024
Date Signed: 11/20/2024 10:06:18 AM

Document Has Been Signed on 11/20/2024 10:06 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PROJECT COMMOTION-LAS LUCIERNAGASFACILITY NUMBER:
384004459
ADMINISTRATOR/
DIRECTOR:		OSTERHOFF, SUSANFACILITY TYPE:
850
ADDRESS:2095 HARRISON STREETTELEPHONE:
(415) 252-8059
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 12TOTAL ENROLLED CHILDREN: 12CENSUS: 11DATE:
11/20/2024
TYPE OF VISIT:POCUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:10 AM
MET WITH:Cristina PonceTIME VISIT/
INSPECTION COMPLETED:
10:15 AM
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On 11/20/2024 at 9:10AM., Licensing Program Analyst (LPA) Luis Gomez and met with Director, Cristina Ponce. The purpose of today’s inspection was explained and was for an unannounced, plan of correction inspection established on 11/12/2024. Present was director and 3 staff supervising for 11 children. Children present had been sign-in. LPA inspected facility for health and safety hazards.

During inspection, LPA conducted record review, observation, and interview.

On 11/15/2024, the Department received an updated disaster drill log, with pertaining documents from facility.
Per director, facility emergency disaster drill was conducted on 11/13/2024, with 5 staff and 10 children present. Director stated next drill is scheduled for March, 2025.

Facility emergency disaster plan (LIC610) was reviewed during inspection.

Deficiency issued on 11/12/2024 has been cleared and ‘Letter of deficiency citation cleared’ was provided.

Based on today's inspection, no deficiencies were observed in areas evaluated according to the Title 22 Division 12, Chapter 1 Ca. Code of Regulations. Exit interview and report was discussed with Director, Cristina Ponce. Signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice of site visit was provided and shall remain posted for 30 days. The director was advised for additional questions to call CCL Office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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