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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004132
Report Date: 02/06/2025
Date Signed: 02/06/2025 04:25:35 PM

Document Has Been Signed on 02/06/2025 04:25 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:ALL FIVE @ BELLE HAVEN (PS)FACILITY NUMBER:
414004132
ADMINISTRATOR/
DIRECTOR:
GARCIA LOPEZ, AUSTREBERTAFACILITY TYPE:
850
ADDRESS:415 IVY DRIVETELEPHONE:
(650) 394-7328
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY: 60TOTAL ENROLLED CHILDREN: 49CENSUS: 45DATE:
02/06/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:45 AM
MET WITH:Director, Helen LuisTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On 02/06/2025, Licensing Program Analysts (LPAs) Katie Krenn and Leslit Tapia-Mandujano conducted an unannounced case management incident inspection. LPAs met with the Executive Director, Helen Luis, the Director of Finance and Operations, Ana Guanzon, as well as the Family Coordinator, Marla Romero. LPAs explained the purpose of today's visit was to discuss two separate self reported unusual incidents.

During today's visit, LPAs conducted a health and safety physical plant inspection. Present in the facility were 45 preschool age children, supervised by ten staff. Facility met teacher to child ratio. All staff present have finger print clearance and are associated to the facility.

Facility self reported two separate incidents that occurred on 01/23/2025. One incident was reported to the department on 01/23/25 and the second incident was reported on 01/24/25. The first incident that the facility reported was a Child #1 (C1) who made inappropriate body movement towards Child #2 (C2) inside of a classroom. The second incident involved Child #1 (C1) later displaying inappropriate body movement towards Child #3 (C3) during outdoor play.

During today's inspection, LPAs spoke with facility administration team to gather additional information. LPAs also interviewed three staff who observed the incidents to clarify the details regarding the incidents. Based on conversations held, facility was proactive in reporting to appropriate departments and notifying the families of the children involved. Facility is actively taking steps to improve the handling of similar situations. Staff came together to collectively support C1 and the safety of other children. Administrative staff is going to continue supporting staff and further develop appropriate processes.

No deficiencies were issued today under CCR, Title 22, Div. 12, Chapt. 1.

A Notice of Site Visit was given and must remain posted for 30 days. An exit interview was conducted and report was reviewed and provided to Executive Director, Helen Luis.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Katie Krenn
LICENSING EVALUATOR SIGNATURE: DATE: 02/06/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/06/2025
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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