214005498-2-16-2023-05-CC-NGAA-CP4S8R-20230216123934

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005498
Report Date: 02/16/2023
Date Signed: 02/16/2023 12:39:47 PM

Document Has Been Signed on 02/16/2023 12:39 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	KINDERBLAST PRESCHOOL		FACILITY NUMBER:	214005498
ADMINISTRATOR:	GRUENHEIDT, KATJA		FACILITY TYPE:	850
ADDRESS:	102 MARINDA DRIVE		TELEPHONE:	(415) 843-1730
CITY:	FAIRFAX	STATE: CA	ZIP CODE:	94930
CAPACITY: 30	TOTAL ENROLLED CHILDREN: 30	CENSUS: 24	DATE:	02/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:19 AM
MET WITH:	Katja Gruenheidt		TIME COMPLETED:	12:50 PM

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 February 16, 2023 at approximately 10:00 AM, Licensing Program Analyst (LPA) Nathan Garcia met with Site Director, Katja Gruenheidt for an unannounced annual inspection. Purpose of the inspection was explained. Present in the facility are 7 teachers, including floaters, supervising 24 children. Facility is operating within its capacity and is in compliance with staff/child ratio on this day. Facility operates day care Monday - Friday 8:00am to 5:30pm. With Supervisor, LPA inspected 2 day care rooms and the outdoor space. LPA observed facility has combined smoke detectors and carbon monoxide detectors, 3 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. Facility has enough sleeping cots/mats available in the facility. The blankets are brought from home and washed at home on Fridays. Individual items provided by the parents are labeled and stored appropriately. According to Katja, there are two PM snacks prepped and served at the facility. The lunches and AM snacks are brought from home. Per director, the children are provided through kitchen sink as main source of drinking water, as needed. The water is filtered through Brita water pitchers and water bottles are brought from home. Foods are tree nut-free and food preparation area is free of litter. 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. *page 2 for continuation*

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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

FACILITY NAME: KINDERBLAST PRESCHOOL	FACILITY NUMBER: 214005498
	VISIT DATE: 02/16/2023

NARRATIVE

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LPA observed outdoor area and play structures are free from health and safety hazards. The sand boxes are well maintained and checked/covered after each use. There are a variety of bicycles and sport equipment available for the children. There are also sheds/bins and storage areas for the toys when they're not being used.

According to Katja, the facility has not done the water lead testing due on January 1, 2023. The facility does have a scheduled test on 2/25/2023. LPA advised director to keep the department updated.

According to the director, the facility is using ProCare for sign in/out. LPA observed that all authorized representatives have signed. 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 January 31, 2023. Per Katja drills are done every 3-4 months.

The LPA reviewed the facility records. LPA reviewed 6 random children's files. All required files were available in folders. LPA reviewed 4 staff files with qualifying requirements such as ECE Units, CPR and Mandated Reporter Training. The facility has a set learning curriculum that includes story time, and movement 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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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

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

FACILITY NAME: KINDERBLAST PRESCHOOL	FACILITY NUMBER: 214005498
	VISIT DATE: 02/16/2023

NARRATIVE

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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.

This facility provides Incidental Medical Services – IMS. According to the director, there are 3 children with allergies. LPA checked and observed that the medications were properly stored. 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

Type B violation for incomplete water lead testing. Director will send the results, once available.

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

Report was reviewed and signed by Site Manager, Katja Gruenheidt.

Today’s report, and notice of site visit will be printed and given to the director.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 02/16/2023 12:39 PM - It Cannot Be Edited

Created By: Nathan Garcia On 02/16/2023 at 12:23 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: KINDERBLAST PRESCHOOL	FACILITY NUMBER: 214005498
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/16/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview, the licensee did not comply with the section cited above for not having drinking water tested for lead, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/31/2023
	Plan of Correction
1 2 3 4	Director will send the water lead sampling results to the department or LPA by due date, 3/31/23.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Daniel J Oquendo

LICENSING EVALUATOR NAME:

Nathan Garcia

LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023

LIC809 (FAS) - (06/04)

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