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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004114
Report Date: 11/29/2022
Date Signed: 11/29/2022 11:16:50 AM

Document Has Been Signed on 11/29/2022 11:16 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:PAPILLON PRESCHOOL MANAGED BY BRIGHT HORIZONSFACILITY NUMBER:
414004114
ADMINISTRATOR:JENNY HOBSONFACILITY TYPE:
850
ADDRESS:1311 SO. EL CAMINO REALTELEPHONE:
(650) 340-7241
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY: 84TOTAL ENROLLED CHILDREN: 84CENSUS: DATE:
11/29/2022
TYPE OF VISIT:OfficeANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Catherine Trabanino, Jenny Hobson and Brian HeathTIME COMPLETED:
11:30 AM
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On 11/29/2022, Regional Manager (RM), Suzanne Roman- Clark, Licensing Program Manager (LPM), Cindy Interiano, and Licensing Program Analyst (LPA), Luis Gomez, met with Site Director, Jenny Hobson, Regional Manager, Catherine Trabanino, and Divisional Vice President, Brian Heath(via phone).
The purpose of meeting was explained and was for a Non-compliance conference. After further discussion, meeting was changed to an Informal/ Office meeting since it was deemed more appropriate. Meeting was to discuss repeat violations cited for lack of supervision cited on 4/5/2022, and 10/14/2022. The following incidents have been self- reported to the San Bruno Regional Office:
-3/1/2022, Child was left unattended inside classroom
-4/20/2022, Two children entered facility unattended from the outdoor play area
-7/8/2022, Child was left in outside play yard during transition
-9/20/2022, Child found in bathroom unattended
Regional Manager, Catherine, stated follow-up actions including the following:
Employees involved in incidents are no longer with facility. Director will implement review areas in the physical plant using postings throughout the facility for staff to ensure they have reviewed all children are present:
-Site Director has reviewed job expectations with staff
-Facility has implemented an electronic tracking sheet for staff
-Monthly, Biweekly training's with staff will included: Proper Care and Supervision of children.

Facility was advised to post the Case Management report (LIC809, LIC809D) for parents and guardians of children in care at the facility and to parents/guardians of children newly enrolled at the facility during the next 12 months.

All parents must sign the LIC 9224 as proof of receipt of facility evaluation report.
Facility will be placed on a Required Annual Visit list. Report was read and reviewed by all parties. Copy was provided to facility.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/29/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/29/2022
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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