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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004637
Report Date: 11/08/2023
Date Signed: 11/08/2023 12:56:16 PM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 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
09/13/2023 and conducted by Evaluator Maria Olguin-Leon
COMPLAINT CONTROL NUMBER: 05-CC-20230913084017
FACILITY NAME:BUILDING KIDZ SCHOOLFACILITY NUMBER:
414004637
ADMINISTRATOR:FRIEDLIN, LINDAFACILITY TYPE:
850
ADDRESS:1633 LAUREL STREETTELEPHONE:
(650) 718-6800
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY:72CENSUS: 40DATE:
11/08/2023
UNANNOUNCEDTIME BEGAN:
09:54 AM
MET WITH:Komal RajputTIME COMPLETED:
01:15 PM
ALLEGATION(S):
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Staff did not ensure child's diaper was changed in a timely manner
INVESTIGATION FINDINGS:
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On November 8, 2023, Licensing Program Analyst (LPA) Maria Olguin-Leon, conducted an unannounced visit to close the complaint investigation into the above allegation and met with Director Komal Rajput. LPA and Director conducted a health and safety tour of facility. Present during today’s visit was Director, 7 staff and 40 children (11 toddlers and 29 preschool age).

Based on investigation and information gathered through record review, interviews conducted and physical tour of the facility, the allegation Staff did not ensure child's diaper was changed in a timely manner, the preponderance of evidence standards has been met, therefore, the above allegation is found to be SUBSTANTIATED. A Type “B” violation was issued today in accordance to the California Code of Regulations, Title 22, Division 12, Chapter 1, citation was being cited on the attached LIC9099D

This report and exit interview were conducted and appeal rights was given to Director, Komal Rajput. This report must be available in the facility for public review. Notice of site visit was provided and must remain posted for 30 days.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
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 2
Control Number 05-CC-20230913084017
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

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

FACILITY NAME: BUILDING KIDZ SCHOOL
FACILITY NUMBER: 414004637
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/08/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Request Denied
Type B
11/09/2023
Section Cited
CCR
101428(b)(2)
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101428 Infant Care Personal Services: (b)The infant shall be kept clean and dry at all times. (2)Each infant's clothing and diapers shall be changed as often as necessary to ensure that the infant is clean and dry at all times.

This requirement is not met as evidenced by:
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Per Director, facility uses Buildingkidzconnect app to document diaper changes. Director will have staff document diaper changes on paper as a secondary back up. Director will submit copy of diaper logs facility will use.
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Based on information gathered, record review, and interviews, LPA confirmed, this requirement has not been met, Staff did not ensure child's diaper was changed in a timely manner, which poses a potential health, safety, or personal rights 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: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 11/08/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/08/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 2