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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213002273
Report Date: 06/28/2023
Date Signed: 06/28/2023 02:59:25 PM


Document Has Been Signed on 06/28/2023 02:59 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:LITTLE SCHOOL- TIBURON, THEFACILITY NUMBER:
213002273
ADMINISTRATOR:DOBRIN, HEATHERFACILITY TYPE:
850
ADDRESS:11 SHEPHERD WAYTELEPHONE:
(415) 435-3521
CITY:TIBURONSTATE: CAZIP CODE:
94920
CAPACITY:32CENSUS: 21DATE:
06/28/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:57 PM
MET WITH:Heather DobrinTIME COMPLETED:
03:15 PM
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On June 28, 2023 at approximately 12:50 PM, Licensing Program Analyst (LPA) Nathan Garcia met with Site Director, Heather Dobrin for an unannounced annual inspection. Purpose of the inspection was explained. There were a total of 21 children and 3 teachers present in the facility, the children were observed during indoor play time. Facility operates day care Monday - Friday 8:15-2:15pm throughout the year.

With Director, LPA inspected day care rooms and the outdoor space. LPA observed facility has multiple smoke detectors and carbon monoxide detectors, 2 fully charged fire extinguisher model 3A40GR located on multiple areas. 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. Individual items provided by the parents are labeled and stored appropriately. According to Heather, the facility does not serve food at the facility, except for Wednesdays for pizza days which is purchased and ready to eat. The parents provide food from home for lunch and AM/PM snacks and all diet sensitivities are accommodated. Per director, the children are provided through Arrowhead dispensers and water services as main source of drinking water, refilled as needed. The kids mainly bring their water bottles from home. All food is stored properly to avoid contamination. Food 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.

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SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/28/2023
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 3


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: LITTLE SCHOOL- TIBURON, THE
FACILITY NUMBER: 213002273
VISIT DATE: 06/28/2023
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LPA observed outdoor area and play structures are free from health and safety hazards. The outdoor area has a large yard with slides and structures and padded floors with shade. There are a variety of toys and sport equipment available for the children. There are also sheds/bins and storage areas for the toys when they're not being used. There are no pools or open bodies of water in the facility.

According to Heather, the facility has not done the water lead testing because the facility does not prepare food or use water from their faucets for ingestion. The facility uses water services through dispensers. LPA advised Heather to request for a waiver/exemption for the lead water testing of the facility.

According to the director, the facility is using paper sign in/out sheets. 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 April 2023. Per Heather, drills are done at least every 6 months, rotating them between lock down/fire and earthquake drills. For napping/resting, the children have the opportunity to rest their bodies during story and circle time.

The LPA reviewed the facility records. LPA reviewed 6 children's files that were present at the time. All required files were available in folders. LPA reviewed 3 staff files with qualifying requirements such as ECE Units, CPR except updated Mandated Reporter Training. The facility has a set learning curriculum posted in the classroom.



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 OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LITTLE SCHOOL- TIBURON, THE
FACILITY NUMBER: 213002273
VISIT DATE: 06/28/2023
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Director has made 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.

This facility provides Incidental Medical Services – IMS. According to the director, there is one children with allergies that needs Epipen. 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

Technical Violation for mandated reporter training for all staff members.

Report was reviewed and signed by Site Director, Heather Dobrin .

Today’s report, and notice of site visit will be printed and given to the director.
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/28/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/28/2023
LIC809 (FAS) - (06/04)
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