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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001492
Report Date: 11/27/2023
Date Signed: 11/27/2023 01:09:14 PM

Document Has Been Signed on 11/27/2023 01:09 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SHORES CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414001492
ADMINISTRATOR:BECKER, LISAFACILITY TYPE:
850
ADDRESS:1050 TWIN DOLPHIN DRIVETELEPHONE:
(650) 594-1100
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94065
CAPACITY: 158TOTAL ENROLLED CHILDREN: 158CENSUS: 75DATE:
11/27/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Deanna CastilloTIME COMPLETED:
01:15 PM
NARRATIVE
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On 11/27/2023 at 8:50AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Assistant Director, Deanna Castillo. Purpose of the inspection was explained. Per Assistant Director, Director is currently on vacation. This case management report is to cite for deficiencies observed during facility's complaint inspection. Present was the Assistant Director and 10 staff supervising 75 children. LPA inspected facility, indoors and outdoors for health and safety hazards.

At 10:45AM., Based on observation, interview and record review, LPA confirmed Starfish/ Seals classroom operating out of ratio, with one teacher and aide supervising 19 children.



Based on today’s inspection, deficiencies were observed in areas evacuated according to the Title 22, Division 12, Chap, 1 of Ca, Code of Regulations and cited on the 809D. An exit interview, appeal rights, and plans for correction was discussed with the Assistant Director, Deanna Castillo. Signature of this form acknowledges the receipt of these documents.

Notice of site visit was given and shall remain posted for 30 days.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/27/2023
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 11/27/2023 01:09 PM - It Cannot Be Edited


Created By: Luis Gomez On 11/27/2023 at 10:26 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: SHORES CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414001492

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/04/2023
Section Cited
CCR
101216.3(b)

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101216.3(b) Teacher- Child Ratio: The licensee may use teacher aides in a teacher-child ratio of one teacher and one aide for every 15 children in attendance. This requirement was not met as evidenced by:
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Facility will ensure compliance with required staff-child ratios, submitting each classrooms updated enrollment log with names of staff (and backups) by the due date: 12/4/2023.

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At 10:45AM., Based on observation, interview and record review, LPA confirmed Starfish/ Seals classroom operating out of ratio, with one teacher and aide supervising 19 children. This poses a potential health and safety risk to children in care.
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Facility will submit document to the LPA via email.

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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:Marie Rodriguez
LICENSING EVALUATOR NAME:Luis Gomez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/27/2023


LIC809 (FAS) - (06/04)
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