<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004507
Report Date: 08/08/2023
Date Signed: 10/23/2023 05:09:53 PM

Document Has Been Signed on 10/23/2023 05:09 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:LAKEVIEW MONTESSORIFACILITY NUMBER:
414004507
ADMINISTRATOR:BRAMHE,SHEILAFACILITY TYPE:
840
ADDRESS:31 VISTA AVENUETELEPHONE:
(650) 578-9532
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY: 15TOTAL ENROLLED CHILDREN: 15CENSUS: 9DATE:
08/08/2023
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
09:39 AM
MET WITH:Sheila BramheTIME COMPLETED:
01:25 PM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
*************** THIS IS AN AMENDED REPORT FROM ORIGINAL DATED 08/08/2023 *********************

On 8/8/23, Licensing Program Analyst (LPA) Garcia made an unannounced case management visit to the child day care facility listed above and met with Assistant Director, Fidaa Salim and later joined by Director, Sheila Bramhe. The case management visit is from a self reported incident. The school age license had 9 children and 1 teacher in the classroom. The whole site with the preschool and school age total is 53 with 8 teachers.

On July 20, 2023, the facility was visited by San Mateo Police regarding a complaint from a parent with one of the staff members hurting a child in care. The police conducted interviews of the director and staff member. Per staff, the police also obtained a copy of the video recording of the incident but the facility has not heard back from the parents or the police department. During the visit, LPA Garcia conducted interviews of the assistant director and teachers. LPA Garcia also obtained a copy of the video recording of the incident and the teacher sent images of the marks on the child that were sent by the parents to the director on the evening of 7/19/23. The child does not attend the school, since the day of the incident.

Type B deficiency is given today under California Code of Regulations, Title 22, Division 12.

101223 Personal Rights

Exit interview was conducted and report was reviewed with director, Sheila Bramhe.

Notice of Site Visit is given to director and must be posted for 30 days at the facility.

The reports and Notice of site visit will be emailed to the director due to printer malfunction and confirmation that it was received is required.
SUPERVISORS NAME: Carol Marcroft
LICENSING EVALUATOR NAME: Cindy Interiano
LICENSING EVALUATOR SIGNATURE: DATE: 08/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/08/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2
Document Has Been Signed on 10/23/2023 05:11 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 10/23/2023 05:05 PM


Created By: Cindy Interiano On 08/08/2023 at 12:13 PM
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LAKEVIEW MONTESSORI
FACILITY NUMBER: 414004507

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
08/09/2023
Section Cited
CCR
101223

1
2
3
4
5
6
7
***Amended Deficiency***

101223 Personal Rights

(a) The licensee shall ensure that each child is accorded the following personal rights.

This requirement is not met as evidenced by:
1
2
3
4
5
6
7
The facility will implement a training course for all staff members regarding children's personal rights.
8
9
10
11
12
13
14
Based on observation, and interview, the staff member did not comply with the section cited above by violating the personal rights of the child, which poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Licensee will submit proof of corrections to LPA by due date.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Carol Marcroft
LICENSING EVALUATOR NAME:Cindy Interiano
LICENSING EVALUATOR SIGNATURE:
DATE: 08/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/08/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2