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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004906
Report Date: 11/28/2022
Date Signed: 11/28/2022 03:42:25 PM

Document Has Been Signed on 11/28/2022 03:42 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, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:AFTERSCHOOL CARE ENRICHMENT (ACE) @ BRITTAN ACRESFACILITY NUMBER:
414004906
ADMINISTRATOR:CASTILLO TABOADA, SHAROLFACILITY TYPE:
840
ADDRESS:2000 BELLE AVENUETELEPHONE:
(650) 264-8006
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 63DATE:
11/28/2022
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
01:50 PM
MET WITH:Sharol TaboadaTIME COMPLETED:
03:50 PM
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On November 28, 2022 at 1:50 PM, Licensing Program Analyst (LPA) Cowan met with site director Sharol Taboada for an Case Management inspection. The reason for the visit is explained. Present in the facility is director, seven staff, and 62 children in care. This inspection is due to an incident report where the facility self reporting that a child's hand was caught in the door jam of room 18, and child was seriously injured on November 16, 2022. On this day, LPA interviewed Licensee, director, and staff. The facility uses two classrooms on Brittan Acres Elementary School (Room 17 and 18).

Per director, a staff member closed the door to give another teacher and child privacy to discuss troubling issues to the child. Per director, the teacher did not see that the child was there with fingers in the jam of the door. Director states that the child upon seeing the injury, 911 was called immediately as well as child's parents. The child went to the hospital and received immediate care. Facility's licensee has altered door by removing part of the door and placing rubber cushion in the jam to prevent so serious an injury. Director states that she has implemented making sure that more staff are stationed in the classrooms at all times, staff are to be more attentive of children around the door, and doors are to remain open at all times during day care hours.

There were no citations issued during this visit.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE: DATE: 11/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/28/2022
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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