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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 013419488
Report Date: 04/04/2022
Date Signed: 04/04/2022 01:56:17 PM

Document Has Been Signed on 04/04/2022 01:56 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612
FACILITY NAME:BRIGHT HORIZONS AT DUBLINFACILITY NUMBER:
013419488
ADMINISTRATOR:NEIBERGER, SUSANFACILITY TYPE:
850
ADDRESS:7035 DUBLIN BLVDTELEPHONE:
(925) 479-9573
CITY:DUBLINSTATE: CAZIP CODE:
94568
CAPACITY: 97TOTAL ENROLLED CHILDREN: 97CENSUS: 35DATE:
04/04/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
12:25 PM
MET WITH:Susan NeibergerTIME COMPLETED:
02:10 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
On 04/04/2022 Licensing Program Analyst (LPA) Jaylena Miller arrived for an unannounced case management inspection and met with facility director Susan Neiberger and explained the purpose of today’s inspection.

On 03/25/2022 director called in an unusual incident to the desk duty analyst that on 3/24/2022 around 8:33am, C1 was dropped off in the kindergarten prep class by his father. At 8:40am another parent who was dropping off her child noticed C1 wandering around the class without a teacher present and escorted him to the preschool class room. The director was on a fire inspection tour with the fire inspector during the incident. C1 was left unattended for 6-7 minutes. Per California Code of Regulations Title 22, Division 12 Chapter 1 Article 06 section 101229(a)(1) Responsibility for Providing Care and Supervision was not met. Based on information obtained and interviews conducted, it is concluded that the facility did not have complete physical and visual supervision of C1 when he was dropped off. LPA explained to the director that Absence of Supervision poses an immediate risk to the health and safety of children in care and comes with A Type A deficiency and immediate civil penalty of $500. However, the facility did call in the incident immediately to licensing and since the child was unharmed and unaffected, the department will issue a Technical Violation for absence of supervision. LPA and director discussed in detail on how to prevent this from happening in the future.

A notice of site visit was given and must be posted for 30 days and this report shall remain on file for 3 years. Exit interview conducted with director Susan Neiberger, a copy of this report, appeal rights, the technical violation and plan of correction were given, and signature acknowledges receipt.
SUPERVISORS NAME: Wynn Norona
LICENSING EVALUATOR NAME: Jaylena Miller
LICENSING EVALUATOR SIGNATURE: DATE: 04/04/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/04/2022
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 1