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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504406
Report Date: 04/13/2023
Date Signed: 04/13/2023 03:33:54 PM


Document Has Been Signed on 04/13/2023 03:33 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:SFUSD-SAN MIGUEL EARLY EDUCATION SCHOOL (PS)FACILITY NUMBER:
380504406
ADMINISTRATOR:ANITA TONG, DIRECTORFACILITY TYPE:
850
ADDRESS:300 SENECA AVENUETELEPHONE:
(415) 469-4756
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:102CENSUS: 85DATE:
04/13/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Anita TongTIME COMPLETED:
02:00 PM
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Licensing Program Analyst (LPA) Yee conducted a Required - 1 Year inspection today. The purpose of the inspection was explained. Present at the facility are the site director, Anita Tong, 14 staff members, and 85 children. Teacher-to-child ratios were met during today's visit. Days and hours of operation: Monday - Friday, 7:45 am - 5:45 pm. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide detector. The outside yard is adjacent to the classroom.

LPAs and Ms. Tong toured and inspected the Center for Health and Safety Hazards. Daycare areas: classroom #14, 15, 16, 18, and 19. The outside yard was inspected. There are no pools, spas, or other bodies of water on the premises. All cleaning supplies and other potentially harmful items are made inaccessible to the children. Furniture and equipment are in good condition. Isolation for a sick child is available in the site director office. The facility provides morning, and afternoon snacks and lunches. Drinking water is provided indoors and outdoor. The last Emergency Drill was conducted on 10-26-22 and properly logged.

During the inspection, LPA reviewed 14 staff’ members' files and was in order. At least one staff have current Pediatric First Aid and CPR on file (11/05/24). Children's files were reviewed and in order. The facility has posted all the required licensing forms in a prominently visible location.


LPA discussed Child Abuse Mandated Training AB1207 with the Site manager. As of January 1, 2018, all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. All staff members have current AB1207 certificates.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/13/2023
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 2


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: SFUSD-SAN MIGUEL EARLY EDUCATION SCHOOL (PS)
FACILITY NUMBER: 380504406
VISIT DATE: 04/13/2023
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Pesticide regulations were discussed with the Site director. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Pesticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

The site director was reminded that all adults 18 years and older working at the facility, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, before initial presence in a licensed 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.

This facility provides Incidental Medical Services-IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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

Facility was also informed that as of September 1, 2016, a person may not be employed or volunteer at a child care 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.

LPA advised the facility to do a lead water testing if the building was built prior to 2010. The facility may find information under PIN 21021-CCP and 22-06-CCP. Lead water testing was done on 07-23-22. The Lead water testing certificate was obtained today.

Annual fees is current.

An Exit Interview was conducted with Site director. No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jennifer YeeTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/13/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/13/2023
LIC809 (FAS) - (06/04)
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