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Department of
SOCIAL SERVICES

Community Care Licensing


COMPLAINT INVESTIGATION REPORT

Facility Number: 414004681
Report Date: 05/09/2023
Date Signed: 05/09/2023 04:33:42 PM

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
04/12/2023 and conducted by Evaluator April Cowan
PUBLIC
COMPLAINT CONTROL NUMBER: 05-CC-20230412154930
FACILITY NAME:BUILDING KIDZFACILITY NUMBER:
414004681
ADMINISTRATOR:AVALOS, ANABELFACILITY TYPE:
850
ADDRESS:1496 ADOBE DRIVETELEPHONE:
(650) 735-5748
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:72CENSUS: 57DATE:
05/09/2023
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Sophin FrancisTIME COMPLETED:
04:48 PM
ALLEGATION(S):
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9
Facility is odoriferous.

Facility does not have a first aide kit.
INVESTIGATION FINDINGS:
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On May 9, 2023 at 3:00 PM, Licensing Program Analyst (LPA) Cowan met with site director, Sophin Francis, for an unannounced subsequent complaint inspection. The purpose of inspection is explained to licensee, and the inspection is to close the current complaint. Present in the facility is director and 11 staff caring for children.

In today’s inspection, LPA along with site director inspected for health and safety hazards. LPA observed no deficiencies during inspection. During the initial inspection, LPA observed what seemed to be a mildew smell in the facility. LPA inspected the first aid kits and found that they needed to replenished. As of this date, site director has taken action to address and correct both allegations.

Based on LPA’s observations during inspection, the preponderance of evidence standard has been met, therefore the above allegations is founded to be SUBSTANTIATED. California Code of Regulations, (Title 22, Division & Chapter number), are being cited on the attached LIC 9099D.
Substantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
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-20230412154930
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: BUILDING KIDZ
FACILITY NUMBER: 414004681
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/09/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
05/09/2023
Section Cited
CCR
101226(d)
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101226 Health-Related Services
(d) The licensee shall maintain the following first-aid supplies in a location accessible to staff but inaccessible to children:
This requirement was not met as evidenced by:
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Licensee has alread replenished first aid kits as of 5/9/23.
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Based on LPA's observations, licensee did not comply with this regulation in that first aid kits were not maintained or replenished. This is a potential risk to children in care.
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Type B
05/09/2023
Section Cited
CCR
101223(a)2)
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101223 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 was not met as evidenced by:
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Site director has already taken action to clean and remove potential items that would cause the smell as of 5/9/23
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Based on LPA's observations, licensee did not comply with this regulation in that the facility had what seemed to be a mildew smell. This is a potential risk to children in care.
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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: April Cowan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
LIC9099 (FAS) - (06/04)
Page: 2 of 3
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
04/12/2023 and conducted by Evaluator April Cowan
COMPLAINT CONTROL NUMBER: 05-CC-20230412154930

FACILITY NAME:BUILDING KIDZFACILITY NUMBER:
414004681
ADMINISTRATOR:AVALOS, ANABELFACILITY TYPE:
850
ADDRESS:1496 ADOBE DRIVETELEPHONE:
(650) 735-5748
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:72CENSUS: 57DATE:
05/09/2023
UNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Sophin FrancisTIME COMPLETED:
04:48 PM
ALLEGATION(S):
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9
Facility has pests.
Facility has mold.
Facility does not provide a safe environment for day care children.
Facility is in disrepair.
INVESTIGATION FINDINGS:
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On May 9, 2023 at 3:00 PM, Licensing Program Analyst (LPA) Cowan met with site director, Sophin Francis, for an unannounced subsequent complaint inspection. The purpose of inspection is explained to licensee, and the inspection is to close the current complaint. Present in the facility is director and 11 staff caring for children.

In today’s inspection, LPA along with site director inspected for health and safety hazards. LPA observed no deficiencies during inspection. During the course of investigation, LPA interviewed director and staff. LPA has not found any evidence or witnesses of pest and mold. The facility has had a problem with the facility flooring and outdoor turf that was already in the process of being fixed. Facility has also made plans to fix the gate in the play yard, making it more secure.

Although the allegation may have happened or is valid, there is not a preponderance of evidence to prove the alleged violation did or did not occur, therefore the allegation is UNSUBSTANTIATED.
Unsubstantiated
Estimated Days of Completion:
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:

DATE: 05/09/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/09/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC9099 (FAS) - (06/04)
Page: 3 of 3