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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434415794
Report Date: 04/13/2022
Date Signed: 04/13/2022 03:22:07 PM

Document Has Been Signed on 04/13/2022 03:22 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131
FACILITY NAME:BRIGHT HORIZONS AT STEVENS CREEKFACILITY NUMBER:
434415794
ADMINISTRATOR:NANCY CAMPBELLFACILITY TYPE:
850
ADDRESS:4945 STEVENS CREEK BOULEVARDTELEPHONE:
(408) 990-8920
CITY:SANTA CLARASTATE: CAZIP CODE:
95051
CAPACITY: 122TOTAL ENROLLED CHILDREN: 122CENSUS: 59DATE:
04/13/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Sherron Murphy- BrownTIME COMPLETED:
03:30 PM
NARRATIVE
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Licensing Program Analysts (LPA's) Anna Morales conducted a Case Management Visit and was greeted by Executive Director Sherron Murphy-Brown. The purpose for this visit was in response of an Incident that occurred on 3/15/2022. Executive Director Sherron Murphy-Brown stated that a pre-school aged child left his/her classroom without supervision from staff.

LPA conducted interviews with Director Brown, and teachers involved with the incident. LPA, also, toured Early Preschool 2 and 3 classrooms. Both classroom's, 2 and 3 are separated by the children's bathroom. Each classroom has a door on each side of their classrooms where the children can enter/exit to and from. Director stated that the day of the incident there were a total of seven children and two teachers present. On 3/15/22, approximately at 4:10pm, S1 was preparing snacks and S2 was assisting the children to clean and wash their hands. It was during this time, that C1 left the classroom, walked through the bathroom and exited to Preschool 2. S3 ( from another Classroom) was walking by Preschool 2 and observed C1 standing by the window facing the parking lot. Director stated that Preschool 2 was empty because it was their time outside in the play yard.

California Code of Regulations, (Title 22, Division 12 & Chapter 1), is being cited on the attached LIC 809D. A notice of site visit was issued and is to be posted near the facility entrance along with the Type "A" deficiency issued today and both notices must remain posted for 30 consecutive days. The Licensee must provide copies of this report to parents/guardians of children in care at this facility and Acknowledgement of Receipt of Licensing Reports (LIC9224) to parents/guardians of children newly enrolled at this facility during the next 12 months, and parents to return this form with signature to the facility.

Exit Interview was conducted with Executive Director Sherron Murphy-Brown. Appeal Rights given. Due to technical difficulties, LPA was unable to leave a signed copy of this report. LPA will send to Director once she returns to the office.
SUPERVISORS NAME: Diana Stephenson
LICENSING EVALUATOR NAME: Anna Morales
LICENSING EVALUATOR SIGNATURE: DATE: 04/13/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/13/2022
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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Document Has Been Signed on 04/13/2022 04:51 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 04/13/2022 04:51 PM


Created By: Anna Morales On 04/13/2022 at 02:05 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
CCLD Regional Office, 2580 N FIRST STREET, STE. 300
SAN JOSE, CA 95131

FACILITY NAME: BRIGHT HORIZONS AT STEVENS CREEK
FACILITY NUMBER: 434415794

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/13/2022
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
04/14/2022
Section Cited
CCR
101229(a)(1)

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Responsibility for Providing Care and Supervision - (a)The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation.
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Executive Director Sherron Murphy- Brown agreed to submit the written Plan of Correction indicating what steps have been implemented to ensure that the preschool children are supervised at all times (inside and outside the classrooms).
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This requirement was not met as evidenced by: A child was found by a staff member unattended in the Early Preschool 2 classroom on March 15,2022. This poses an immediate risk to the health, safety, and personal rights to children in care.
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According to AB 633, parents must be provided with this report which contains this Type A deficiency for the next 12 months & copy of the signed acknowledgment form must be kept in each child's file.

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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.
SUPERVISOR'S NAME:Diana Stephenson
LICENSING EVALUATOR NAME:Anna Morales
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2022


LIC809 (FAS) - (06/04)
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