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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 410500593
Report Date: 06/27/2023
Date Signed: 06/27/2023 10:24:27 AM

Substantiated


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 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
06/20/2023 and conducted by Evaluator Catrina Quimbo
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230620154302
FACILITY NAME:ST. ANDREW'S PRESCHOOLFACILITY NUMBER:
410500593
ADMINISTRATOR:MCLAUGHLIN, JEANNEFACILITY TYPE:
850
ADDRESS:1600 SANTA LUCIA AVETELEPHONE:
(650) 273-4415
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY:52CENSUS: 24DATE:
06/27/2023
UNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Jeanne McLaughlinTIME COMPLETED:
10:30 AM
ALLEGATION(S):
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Staff did not ensure child's dietary food restrictions were followed.
INVESTIGATION FINDINGS:
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C1= Child #1.

On June 27, 2023 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, complaint visit to St. Andrew's Preschool. LPA met with director, Jeanne McLaughlin, and explained the purpose of the visit.

At start of LPA's visit, children were arriving to facility as it was morning drop off time. Facility is currently conducting a summer program from 06/26/2023 through 08/25/2023 from 7:30am to 5:30pm. Present during visit included 7 staff members with 24 preschool children. Facility is operating within capacity limits and ratio.

On June 15, 2023, director self-reported to department of an incident that occurred at facility. C1 was accidentally provided a food by a staff member, that C1 is allergic to, during program's hours of operation. C1 had an allergic reaction while on site. C1's parents were notified of incident right away and brought C1 for medical attention. Per director, on June 16, 2023, director was notified C1 had recovered and was doing well.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023
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 3
Control Number 05-CC-20230620154302
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: ST. ANDREW'S PRESCHOOL
FACILITY NUMBER: 410500593
VISIT DATE: 06/27/2023
NARRATIVE
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(Continued, Page 2...)
Director stated they had an informal meeting with staff on site to avoid any future incident from occurring. Per director, staff are working on posting children's allergies in all classrooms, maintaining emergency binders and emergency information, further discussing with families on food provided to children, and when to call emergency services.

Based on interview, record review and director self-reporting incident, the preponderance of evidence standard has been met, therefore the above allegation is found to be SUBSTANTIATED. California Code of Regulations, Title 22, Division 12, Chapter 1 are being cited. Please refer to 9099D for more information.

Notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100. Appeal Rights were also provided.

Exit interview conducted and report was reviewed with director, Jeanne McLaughlin.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
Control Number 05-CC-20230620154302
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

COMPLAINT INVESTIGATION 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: ST. ANDREW'S PRESCHOOL
FACILITY NUMBER: 410500593
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/27/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/11/2023
Section Cited
CCR
101227(a)(7)(B)
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101227 Food Services (a)(7)(B) A child shall not be served any food to which the child's record indicates he/she has an allergy.
This requirement was not met as evidenced by:
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Per director, staff had an informal meeting to discuss incident and ways to address any future incident. LPA advised director to hold a formal staff meeting.
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Based on interview and record review, a staff member on site provided an enrolled child a food the child was allergic to, during hours of operation. This poses a potential health, safety or personal rights risk to children in care.
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Formal staff meeting to include meeting agenda, the solutions discussed, staff attendance and staff signatures. Proof of formal meeting to be sent to LPA no later than 07/11/2023 by 5:00pm.
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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: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 06/27/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/27/2023
LIC9099 (FAS) - (06/04)
Page: 3 of 3