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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001226
Report Date: 01/29/2025
Date Signed: 01/29/2025 03:39:43 PM

Document Has Been Signed on 01/29/2025 03:39 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CITY OF PACIFICA - SUNSET RIDGE CHILD CARE CENTERFACILITY NUMBER:
414001226
ADMINISTRATOR/
DIRECTOR:
LISA MENCONIFACILITY TYPE:
840
ADDRESS:340 INVERNESS, RMS. 1 & 2TELEPHONE:
(650) 738-7465
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY: 102TOTAL ENROLLED CHILDREN: 102CENSUS: 35DATE:
01/29/2025
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
03:15 PM
MET WITH:Nicole HernandezTIME VISIT/
INSPECTION COMPLETED:
04:30 PM
NARRATIVE
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On January 29th, 2025 at approximately 3:15 PM, Licensing Program Analyst (LPA) Janet Gil conducted an unannounced case management visit to the City of Pacifica - Sunset Ridge Child Care Center. The purpose of the visit was to follow up with a self reported incident involving a child and a staff member. LPA met with lead teacher, Nicole Hernandez and explained the purpose of the visit. Per Lead teacher, director Cynthia Ussery is not present at the facility on this date. This facility is operating in the Pacifica Sunset Ridge School site in Portables 1 and 2 for after school care. All staff working at the facility have fingerprint clearance on file.

Present during inspection included 35 enrolled children, and 4 staff. After school program currently operates Monday through Friday 7:00 AM to 6:00 PM. Facility is operating within its capacity and in accordance with the required ratio of staff to children.

Lead teacher stated that the incident that occurred on 1/14/2025 is under an internal investigation. Lead teacher was present at facility during incident, however did not witness it. Staff involved in incident has not been present at facility since incident occurred, and has been relocated while incident is under investigation. Per lead teacher, there is a scheduled police interview on 2/5/2025. LPA requested lead teacher to notify the department once their HR department completes internal investigation and police report is complete.

No deficiencies were issued today during LPA's visit.

A copy of today’s report was given to lead teacher, Nicole Hernandez.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with lead teacher, Nicole Hernandez.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE: DATE: 01/27/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/27/2025
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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