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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004115
Report Date: 04/11/2023
Date Signed: 04/11/2023 02:07:17 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
This is an official report of an unannounced visit/investigation of a complaint received in our office on
04/03/2023 and conducted by Evaluator Luis Gomez
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230403143622
FACILITY NAME:PAPILLON PRESCHOOL MANAGED BY BRIGHT HORIZONS INFFACILITY NUMBER:
414004115
ADMINISTRATOR:JENNY HOBSONFACILITY TYPE:
830
ADDRESS:1311 SO. EL CAMINO REALTELEPHONE:
(650) 340-7241
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:24CENSUS: 14DATE:
04/11/2023
UNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Alex Bandares, Jenny Hobson, Catherine TrabaninoTIME COMPLETED:
02:10 PM
ALLEGATION(S):
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Children are left alone with staff not qualified to supervise children alone.
INVESTIGATION FINDINGS:
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On 4/11/2023 at 9:00AM., Licensing Program Analyst (LPA) Luis J. Gomez met with Lead Educator, Alex Banares. Purpose of the inspection was explained and was for an unannounced, complaint investigation. Present were six staff caring for 14 children. Director, Jenny Hobson, Regional Manager, Catherine Trabanino, arrived during inspection. LPA inspected facility for health and safety hazards.

During inspection, LPA performed site observations, interviews and reviewed facility records.

During the course of the investigation, observations were conducted on 4/11/2023. A review of the facility records was complete, which included personnel files, staff roster, and sign-in sheet. LPA conducted interviews with the director, staff and involved parties. (REFER TO LIC9099C, FOR CONT.)
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 1 of 3
Control Number 05-CC-20230403143622
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: PAPILLON PRESCHOOL MANAGED BY BRIGHT HORIZONS INF
FACILITY NUMBER: 414004115
VISIT DATE: 04/11/2023
NARRATIVE
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(Page 2)
Regarding the allegations of children are left alone with staff not qualified to supervise children alone. Based on interviews and record review; LPA determined allegation made are valid. Therefore, the preponderance of evidence standard has been met, with allegation found to be SUBSTANTIATED. California code of Regulations (Title 22, Section 12 Chapter 1) are being cited on attached 9099D.

Exit interview, report, and plan of correction was discussed with Director, Jenny Hobson and Regional Manager, Catharine Trabinino.

Notice of site visit was provided to the facility.
Website for Forms and Regulations: www.ccld.ca.gov. Appeal rights were provided to licensee.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20230403143622
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PAPILLON PRESCHOOL MANAGED BY BRIGHT HORIZONS INF
FACILITY NUMBER: 414004115
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/11/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/21/2023
Section Cited
CCR
101616.5(b)
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101616.5(b) Teacher-Child Ratios:
An infant care aide shall work under the direct supervision of the director, the assistant director or a fully qualified teacher, except as provided for in Section 101416.5(d)(1). This requirement is not met as evidenced by:
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Director will submit updated personnel schedule(LIC500) by the due date: 4/21/2023.
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Based on evidence collected, LPA determine allegation is valid. This poses a potential health and safety risk to children in care.
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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.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3