210109716-5-7-2024-05-CC-NGAA-D52QXN-20240507123350

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 210109716
Report Date: 05/07/2024
Date Signed: 05/07/2024 12:33:59 PM

Document Has Been Signed on 05/07/2024 12:33 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	BELVEDERE TIBURON CHILD CARE CENTER PRESCHOOL		FACILITY NUMBER:	210109716
ADMINISTRATOR:	BURRELL, CRISTY		FACILITY TYPE:	850
ADDRESS:	1185 TIBURON BLVD.		TELEPHONE:	(415) 435-4366
CITY:	TIBURON	STATE: CA	ZIP CODE:	94920
CAPACITY:	60	CENSUS: 20	DATE:	05/07/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Cristy Burrell		TIME COMPLETED:	12:40 PM

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On May 7, 2024 at 9:45 AM, Licensing Program Analyst (LPA) Nathan Garcia met with Director, Cristy Burrell, for an unannounced annual inspection. Purpose of the inspection was explained. There were a total of 20 children supervised by 5 staff members, including the director. Facility operates day care Monday - Friday 7:00am to 6:00pm.

With Director, LPA inspected 4 day care rooms and the outdoor spaces. LPA observed facility has combined fire/smoke detectors and carbon monoxide detectors, LPA tested the functionality of the detectors. LPA observed that room 2 is currently not used and per director, it is used as a storage room. Per Cristy she is planning to clear it and utilize the space. There are fully charged fire extinguisher model 3A40BC located on multiple areas and in each rooms. The facility has a working telephone on site. All cleaning solutions, poisons, and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age-appropriate furniture. Facility floor and rugs are in good repair and free of any hazards.

There are first aid supplies available in the classrooms and in the office. All bathrooms are in working condition. All food is stored properly to avoid contamination. Individual items provided by the parents are labeled and stored appropriately. According to Cristy, the facility serves morning, and afternoon snacks. Lunches are brought from home, provided by the parents. Per director, the children are provided through sink water for refill, as needed. The children have bring their water bottles from home. Food preparation area is free of litter and is stored adequately to prevent contamination and properly labeled. There is water available for children in the yard as well as in the classrooms and emergency bags.

LPA observed outdoor areas and age appropriate play structures are free from health and safety hazards. The outdoor area has shaded areas for the children to rest with a garden, slides and playhouses. There are a variety of toys and carts to ride on available for the children. There are also sheds/bins and storage areas for the toys when they're not being used.

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SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION 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: BELVEDERE TIBURON CHILD CARE CENTER PRESCHOOL	FACILITY NUMBER: 210109716
	VISIT DATE: 05/07/2024

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CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

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.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA has all LIC forms associated with lead water testing prior to the visit. LPA observed and based on record review, the facility completed the lead water testing for both facilities. Preschool License # 210109716 and school age license #214005125. The results are under the the preschool license #210109716. The facility sketch shows the fixtures tested located in the school age rooms.

According to Cristy, the facility is using paper for sign in/out. Facility has license and all other required documents posted and visible for the public. Facility has an emergency drill log and last drill was conducted on February 28, 2024. Per staff, drills are done at least every other month rotating them between fire and earthquake drills and lock down drills.

LPA reviewed the facility records. LPA reviewed 4 child's file during the visit. LPA reviewed 2 staff files with qualifying requirements such as ECE Units, CPR and Mandated Reporter Training.

The Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

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SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BELVEDERE TIBURON CHILD CARE CENTER PRESCHOOL	FACILITY NUMBER: 210109716
	VISIT DATE: 05/07/2024

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Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file.
LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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.

According to staff, there is one child with allergies with Epipen and One child with asthma. LPA checked and verified dates of the medications. Incidental Medical Services – IMS. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

No deficiencies are issued under Title 22, Division 12 Chap. 1 CA Code of Regulations during today's visit.

A copy of this report was given with the “Notice of Site Visit” to the staff. A Notice of Site Visit must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed and signed by director, Cristy Burrell.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

LIC809 (FAS) - (06/04)

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