<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210104612
Report Date: 10/04/2023
Date Signed: 10/04/2023 10:36:16 AM


Document Has Been Signed on 10/04/2023 10:36 AM - 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:KUMARA DAY SCHOOLFACILITY NUMBER:
210104612
ADMINISTRATOR:ROSARIO MARTEL KNUTSONFACILITY TYPE:
850
ADDRESS:540 MARIN AVENUETELEPHONE:
(415) 388-5437
CITY:MILL VALLEYSTATE: CAZIP CODE:
94941
CAPACITY:50CENSUS: 30DATE:
10/04/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
09:46 AM
MET WITH:Rosario Martel KnutsonTIME COMPLETED:
10:50 AM
NARRATIVE
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
On 10/4/23 at approximately 9:45 AM, Licensing Program Analyst (LPA) Nathan Garcia conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with the director, Rosario Knutson. LPA explained the purpose of the visits and was given a tour of the facility.
Present in facility are 31 children, present with 5 staff members.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

The facility received the ALE report from the Vendor on 3/7/2023. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in barricading and putting signs indicating that the water fountain/kitchen fixture is not for drinking and or currently out of order.
The facility was cited for not meeting the January 1, 2023 deadline for lead testing back in February 22, 2023 annual inspection with LPA Leong. After the test, there was an action level exceedance and the affected fixture C (17) is above the 5.5 ppb threshold. The deficiency was cleared on March 23, 2023 when the facility got tested and sent the results. The facility promptly sent a Plan of Correction for that affected fixture, which is a water fountain that has not been used since COVID-19 pandemic. The facility's POC consisted of permanently removing the water fountain and installing a water dispenser at a later date. The LPA observed that fixture C is now permanently removed and per director, the facility has a filtered water dispenser installed in July 2023 at a different location. The facility uses other fixtures that passed for water ingestion and food preparation. LPA Garcia will contact the facility for further instructions, if the facility needs to retest the new filtered water dispenser.

LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), in an email from LPA Leong.

This report was reviewed and signed by Director, Rosario Knutson.

No deficiencies cited for today's visit.

This report and notice of Site visit were provided to the licensee and must remain posted for 30 days.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/04/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/04/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1