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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002475
Report Date: 09/08/2025
Date Signed: 09/08/2025 03:39:26 PM

Document Has Been Signed on 09/08/2025 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:COASTSIDE CHILDREN'S PROGRAMS - MONTARAFACILITY NUMBER:
414002475
ADMINISTRATOR/
DIRECTOR:		SHANNAN GOTSCHALLFACILITY TYPE:
850
ADDRESS:1100 LE CONTE AVENUETELEPHONE:
(650) 728-0174
CITY:MONTARASTATE: CAZIP CODE:
94037
CAPACITY: 40TOTAL ENROLLED CHILDREN: 13CENSUS: 11DATE:
09/08/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:25 AM
MET WITH:Shannan GotschallTIME VISIT/
INSPECTION COMPLETED:
03:55 PM
NARRATIVE
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On 9/8/2025, Licensing Program Analysts (LPAs) Wadhwa and Leong conducted an unannounced annual visit in conjunction with a case management visit for multiple self-reported incidents reported to the department. LPAs met with Director Shannan Gotschall and explained the purpose of the visit.

The facility operates Monday through Fridays 7:30 AM to 5:30 PM. The facility is currently operating out of classroom #1 “Bumble-Bee Room”.

Present during today’s visit are the Director, 6 staff and 11 preschool children. Parents are required to sign in and sign out using wet signatures daily. LPAs advised Director to remind parents of signing children in/out timely, correctly and with full signatures.

The facility license, Child Passenger Restraint System Poster, Notifications of Parents’ Rights, Emergency Disaster Plan, and Personal Rights were displayed on the bulletin board.

The last emergency disaster drill was conducted on 7/31/2025, and documented in the facility log. A review of previous drills confirmed that emergency drills are conducted every month.

The facility is equipped with multiple smoke and carbon monoxide detectors, multiple fully charged fire extinguishers, and multiple first aid – supply kits.

The facility was found to be clean, well maintained, and free from hazards. Disinfectants, cleaning solutions, and toxic substances were inaccessible to the children. All accessible cabinets and drawers in the classrooms contained no hazardous materials.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/08/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 09/22/2025 10:12 AM - It Cannot Be Edited

Document is an Amendment of Original Document on 09/10/2025 03:43 PM


Created By: Ruhi Wadhwa On 09/08/2025 at 02:39 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: COASTSIDE CHILDREN'S PROGRAMS - MONTARA
FACILITY NUMBER: 414002475

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/08/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Please be advised that citation was created in error and should be disregarded.
POC Due Date: 09/09/2025
Plan of Correction
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Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Ruhi Wadhwa
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/08/2025


LIC809 (FAS) - (06/04)
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Document Has Been Signed on 09/08/2025 03:39 PM - It Cannot Be Edited


Created By: Ruhi Wadhwa On 09/08/2025 at 02:39 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
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: COASTSIDE CHILDREN'S PROGRAMS - MONTARA
FACILITY NUMBER: 414002475

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/08/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101223(a)(2)
Personal Rights
(a) The licensee shall ensure that each child is accorded the following personal rights: (2) To be accorded safe, healthful and comfortable accommodations, furnishings and equipment to meet his/her needs.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, record review, the licensee did not comply with the section cited above. All three incidents resulted in children being picked up early by parents and taken to the emergency room or their doctor for an evaluation and treatment, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/08/2025
Plan of Correction
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The Director will develop a written plan addressing safety concerns regarding the sandbox and the areas near the sandbox and submit to Department by 9/12/2025. Director will further be accorded 30 days from today (POC due date 10/08/2025), to implement directives in stated plan.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Ruhi Wadhwa
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 09/08/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/08/2025


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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: COASTSIDE CHILDREN'S PROGRAMS - MONTARA
FACILITY NUMBER: 414002475
VISIT DATE: 09/08/2025
NARRATIVE
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The classroom has two guinea pigs housed in a covered enclosure. Per staff, the enclosure is cleaned every day. At the time of inspection, the enclosure appeared to be clean and hygienic. There is also a fish tank in the classroom that is serviced every two weeks. The fish tank is securely fastened to the wall to prevent tipping.

The facility provides a food service Monday through Fridays including a hot breakfast, hot lunch and dry snacks.

LPAs inspected pantry and kitchen areas where food is stored and prepared. LPAs observed the areas to be clean and supplies to be current. Per Director, staff take turns preparing foods and food supplies are restocked every two weeks. Children bring their own water bottles and are refilled at filtered water station as needed.

LPAs observed that mats were provided for the children in care. The facility requires parents to supply blankets and sheets for their children, which are returned on a weekly basis for laundering.

The facility is equipped with age-appropriate toys, furniture, and learning materials. Each child has an individual cubby labeled with their name. The facility has two toilets, two sinks in the children’s bathroom. The bathroom area is clean, fully operational, and equipped with essential sanitation supplies. There is a separate staff bathroom located next to the kitchen.

The outdoor playground is fully enclosed with a fence at least 4 feet tall. No pools, spas, or bodies of water were present on the property.

The outdoor playground area consists of a play structure, a sandbox, and a garden. LPAs observed the play structure “equipment” to be chipping and the handles to be rusty. Per the director, the facility is currently seeking grants to replace the entire play structure.

LPAs observed the sandbox to contain a large amount of sand with excess sand spilling outside the box and thereby creating a slippery surface around the immediate area. LPAs advised the Director to install netting around the sand box with a single entry and exit point to help prevent accidents and placing matting at the entry and exit area, in addition to removing excess sand.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: COASTSIDE CHILDREN'S PROGRAMS - MONTARA
FACILITY NUMBER: 414002475
VISIT DATE: 09/08/2025
NARRATIVE
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 *Amended document*

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LPAs further advised sanding down the play equipment and covering the rusty parts as well as cleaning the garden area to provide more open space for children to run and play safely.

On this day, LPAs also conducted a case management that was related to three incidents that occurred on three separate occasions 6/27/2025, 6/20/2025 and 5/2/2025. All three incidents involved children tripping outside while playing, resulting in head injuries.

On 6/27/2025, a child tripped while running through the sandbox area and hit their face on the wooden rim of the sandbox, resulting in a nose bleed.

On 6/20/2025, a child tripped while running and hit their face on the wooden rim of the play structure resulting in a bruise.

On 5/2/2025, a child tripped while running through the sandbox area and hit their face on the wooden rim of the sandbox resulting in a scrape on their nose.

All three incidents resulted in children being picked up early by parents and taken to the emergency room or their doctor for an evaluation and treatment. LPAs conducted an interview with Director to gather additional information regarding the circumstances of the incident and discussed the prevention of future incidents.

Based on review of incident reports and interview conducted with Director, a Type B deficiency will be issued for personal rights violation due to repeated injuries occurring in the outdoor play area specifically the sandbox area.

LPAs reviewed five children’s files and found them to be complete, including all required licensing forms.
LPAs reviewed six staff files and found valid certificates for Pediatric First Aid/CPR and Mandated Reporter Training.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: COASTSIDE CHILDREN'S PROGRAMS - MONTARA
FACILITY NUMBER: 414002475
VISIT DATE: 09/08/2025
NARRATIVE
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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Facility Representative was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
LIC809 (FAS) - (06/04)
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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: COASTSIDE CHILDREN'S PROGRAMS - MONTARA
FACILITY NUMBER: 414002475
VISIT DATE: 09/08/2025
NARRATIVE
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Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

One Type B deficiency was issued during today’s visit, 9/8/2025.


A copy of this report with the appeal rights was provided, and signature of this form acknowledges the receipt of these documents.

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

Exit interview conducted and report was reviewed with Director, Shannan Gotschall.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Ruhi Wadhwa
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/08/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/08/2025
LIC809 (FAS) - (06/04)
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