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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004477
Report Date: 04/10/2023
Date Signed: 04/10/2023 03:56:00 PM

Document Has Been Signed on 04/10/2023 03:56 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:BANANA FANA PRESCHOOLFACILITY NUMBER:
384004477
ADMINISTRATOR:CASTILLO, CAROLINAFACILITY TYPE:
850
ADDRESS:2701 FOLSOM STREETTELEPHONE:
(415) 654-5114
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 20DATE:
04/10/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Carolina Castillo TIME COMPLETED:
04:00 PM
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On 4/10/2023 at 2:00PM. Licensing Program Analyst, (LPA) Luis J. Gomez met with Site Supervisor, Carolina Castillo. The purpose of today's inspection was explained and is in response to an incident, occurring on 3/3/2023. Incident was self- reported by facility management. Present during inspection was the Site Supervisor and six staff supervising 20 children. Children present had been properly signed in. Licensee, Gloria Morales- Nova arrived during inspection. LPA inspected facility for health and safety hazards.

During the inspection, LPA performed site observations, record review, and interviews.

Unusual incident reported was received by the department on 3/6/2023. Per report, child in program, C1, stating they had been grabbed/ push in neck area, by staff member, S1. Per licensee, incident initiated a subsequent investigation and meetings with C1’s family and staff was held on 3/6/2023. Per licensee, staff S1 has continuously denied the allegation, stating physical intervention has never been used while assisting day-care children. Licensee stated, staff are required to use verbal redirection, and options, when assisting children.

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Chapt. 1. ***

This report and rights to comment and appeal were discussed with Site Supervisor. This report must be available in the facility for public review. Notice of site inspection was posted. Any additional questions to call Office, M-F, 8a-5p, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 04/10/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/10/2023
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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