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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504038
Report Date: 09/11/2024
Date Signed: 09/11/2024 12:40:04 PM


Document Has Been Signed on 09/11/2024 12:40 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:BUEN DIA FAMILY SCHOOLFACILITY NUMBER:
380504038
ADMINISTRATOR:ALDAZ, TERESAFACILITY TYPE:
850
ADDRESS:589 GUERRERO ST.TELEPHONE:
(415) 431-3535
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY:30CENSUS: 24DATE:
09/11/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Adelina Arcelona, Danielle HaimTIME COMPLETED:
12:55 PM
NARRATIVE
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On 9/11/2024 at 8:50AM., Licensing Program Analyst (LPA), Luis Gomez met with Lead Teacher, Danielle Haim. The purpose of today's visit was explained and was for an unannounced, annual random inspection. Director, Adelina Arcelona arrived during inspection. Present was Lead Teacher and 4 staff supervising 24 children. Adults in facility have criminal record clearances on file. Children present had been signed-in by guardians. Days and hours of operation are Monday- Friday, 8:00- 5:30PM. Preschool operated during school year, and is a 10-month program. Per Director, summer session is also provided for families. Program utilizes two classrooms: Areas #1, #2, #3- Classroom #2 (Sol); Classroom #1/ Lower Classroom (Luna); and one, shared, Outdoor Play Yard. Per Director, Classroom #1 on lower level is currently closed for renovation.

During inspection, unusual incident report (LIC624) documenting the classroom closure was submitted to LPA. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 9:00AM., LPA observed the following: Classrooms were clean, neat, with age-appropriate materials and playthings available for the children. Facility was equipped with tables, chairs, and furniture, scaled to the appropriate size. Accessible objects were free of sharp corners or splinters. Labeled cubbies are in entry way, for storage of children’s belongings. The off-limit areas have been made inaccessible with installed child safety gates.

The children’s bathroom was observed clean with toilets and faucets in operating condition. Facility has extra cabinets available for added storage. For rest/ napping services, facility has plastic mats stored in closet. Per lead teacher, blankets and supplies are taken by the families weekly to be washed. Facility had ventilation; adequate lighting; and were a comfortable temperature. Facility had a functioning telephone service; carbon monoxide detector; smoke detector; and fire extinguisher (2A10BC).

Kitchen/ food storage areas was observed free of any liter or rubbish. Food items inspected were current. LPA observed outlets and trash bins (used for solid waste) were covered. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2024
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 6


Document Has Been Signed on 09/11/2024 12:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: BUEN DIA FAMILY SCHOOL
FACILITY NUMBER: 380504038

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/11/2024

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
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At 10:05AM., Based on record review, LPA confirmed facility’s lead testing of water outlets was completed after 1/1/2023. This poses a potential health and safety risk to children in care.
POC Due Date: 09/12/2024
Plan of Correction
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No exceedances were identified by testing. LPA advised facility to submit complementary report and pertaining documents to the Department.

Deficiency cleared during today's inspection.
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 10:30AM., Based on record review, LPA confirmed staff's proof of required immunization missing from facility records. This poses a potential health and safety risk to children in care.
POC Due Date: 09/30/2024
Plan of Correction
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Director will submit staff''s proof of immunization by the due date: 9/30/2024.
Proof of correction will be submitted to the Department via email. LPA provided facility with personnel audit report, LIC859.
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: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/11/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/11/2024
LIC809 (FAS) - (06/04)
Page: 2 of 6


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BUEN DIA FAMILY SCHOOL
FACILITY NUMBER: 380504038
VISIT DATE: 09/11/2024
NARRATIVE
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(PAGE 2)
At 9:20AM, LPA reviewed the outside play yard. Absorbent material has been installed on ground surface for added safety. Areas were completely enclosed with tall fencing, with playthings were in like-new condition. LPA observed water pitchers and cup are taken outside by staff, for children to drink water as they wish.

At 9:21AM., Based on observation, LPA confirmed rodent feces in the outdoor play area. Hazardous item were removed during inspection. Advisory Note: Technical Violation (LIC9102TV) was issued.

At 10:00AM., LPA reviewed the facility records including a sample of the children and personnel files.
At 10:05AM., Based on record review, LPA confirmed facility’s lead testing of water outlets was completed after 1/1/2023.

The personnel files reviewed contained Teacher's Proof of Qualifications; Notice of Employee Rights (LIC9052); and Acknowledgement to Report Suspected Child Abuse (LIC9108).

At 10:30AM., Based on record review, LPA confirmed staff's proof of required immunization missing from facility records.

LPA reminded director to ensure staff renew required mandated reporter training course (AB1207) every two years. Advisory Note: Technical Violation (LIC9102TV) was issued.

Children’s files were reviewed and contained the: Notification of Parent’s Rights (LIC995); Immunization Record; and Personal Rights (LIC613A); Consent form for Medical Treatment (LIC627), and Identification and Emergency Information (LIC700).

Present staff’s CPR/ First Aid certification was current, expiring on: 2/16/2026.
Emergency disaster drills every six months, with last drill completed on 7/19/2024, properly logged.

Required postings in lobby and included the: Facility License; Notification of Parent’s Rights (PUB394); Personal Rights (LIC613A); The Passenger Safety Laws Form (PUB269); and Emergency Disaster Plan (LIC610).

The children’s medication was reviewed during inspection. (REFER TO 809C, FOR CONT.)
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024
LIC809 (FAS) - (06/04)
Page: 6 of 6
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BUEN DIA FAMILY SCHOOL
FACILITY NUMBER: 380504038
VISIT DATE: 09/11/2024
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(PAGE 3)
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on 809D. An exit interview discussing the plans for correction, facility evaluation report was conducted with Lead Teacher, Danielle Haim. Staff’s signature on this form acknowledges receipt of these documents.



This report must be made available in facility for public review. Notice of site visit was provided and must remain posted for 30 days. Staff was advised, any additional questions/ concerns to contact the office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/11/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2024
LIC809 (FAS) - (06/04)
Page: 5 of 6