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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004601
Report Date: 02/28/2024
Date Signed: 02/28/2024 04:01:28 PM

Document Has Been Signed on 02/28/2024 04:01 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:SFUSD-GEORGE WASHINGTON CARVER ELEMENTARY SCHOOLFACILITY NUMBER:
384004601
ADMINISTRATOR:LEWIS, CATHERINEFACILITY TYPE:
850
ADDRESS:1360 OAKDALE AVENUETELEPHONE:
(415) 330-1540
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94124
CAPACITY: 144TOTAL ENROLLED CHILDREN: 144CENSUS: 46DATE:
02/28/2024
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Kamael BurchTIME COMPLETED:
04:16 PM
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On February 28, 2024, Licensing Program Analyst (LPA) Sheran Lo conducted a case management inspection and met with Director Kamael Burch. This is regarding an unusual incident report received on 2/22/24 submitted by Director. Purpose of the inspection was explained to Director. Present were Director, 15 teachers, with 46 children in care.

Discussed during the inspection was the details of the incident and what the facility internal investigation found out through interviewing staff and parents. No violation was found on this day.


Exit interview was conducted with Director Kamael Burch. Report and Notice of Site Visit was provided. Notice of Site Visit will be posted for 30 days.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Sheran Lo
LICENSING EVALUATOR SIGNATURE: DATE: 02/28/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/28/2024
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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