380505027-4-19-2023-05-CC-CQUO-CR32DM-20230419171835

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380505027
Report Date: 04/19/2023
Date Signed: 04/19/2023 05:18:47 PM

Document Has Been Signed on 04/19/2023 05:18 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:	CLARENDON BEFORE AND AFTER SCHOOL CHILDCARE CENTER		FACILITY NUMBER:	380505027
ADMINISTRATOR:	POPE, SHELLEY L.		FACILITY TYPE:	840
ADDRESS:	500 CLARENDON AVENUE		TELEPHONE:	(415) 699-4170
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	160	CENSUS: 143	DATE:	04/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:20 PM
MET WITH:	Shelley Pope		TIME COMPLETED:	05:45 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 April 19, 2023 at approximately 2:20pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee, Shelley Pope, and explained the purpose of the inspection. Program is an after school program that operates on Clarendon Elementary School. Program is currently operating in cafeteria, school library, upper school yard and lower school yard. Hours of operation include both morning and after school hours. Morning hours of operation are Monday through Friday 7:30am to 9:30am. After school hours of operation are Monday, Tuesday, Thursday and Friday 3:45pm to 6:30pm and Wednesdays 2:30pm to 6:30pm. Present during LPA's visit included 143 children with 12 staff members (including licensee/director). Facility is operating within capacity limits and ratio during LPA's visit. LPA observed all staff members working with after school program to have fingerprint clearance on file. With licensee, LPA inspected day care areas for health and safety hazards. LPA observed day care areas to be clean and well ventilated. Day care areas have a variety of age appropriate toys, materials, and furnishings that were in good working condition. Facility is equipped with multiple fire extinguishers and a smoke alarm system. Per licensee, smoke alarm system is a dual carbon monoxide and smoke detector that entire facility has installed. Cafeteria for after school program's use includes a first aid cabinet that was observed to be fully stocked. Children's medications were made inaccessible in an off limit area that only staff have access to. LPA observed cleaning solutions, poisons and other hazardous materials to be stored inaccessible in off limit areas and/or located on high shelves. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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

FACILITY NAME: CLARENDON BEFORE AND AFTER SCHOOL CHILDCARE CENTER	FACILITY NUMBER: 380505027
	VISIT DATE: 04/19/2023

NARRATIVE

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Storage for children's belongings are located both inside and outside the cafeteria. Restrooms children have access to were observed to be in proper working condition with appropriate sanitation products. Sinks children have access to do not provide water that is warmer than 120 degrees Fahrenheit. Restrooms allow for school age children's individual privacy.

Outdoor area is entirely enclosed with an at least 5 ft. high fence. Upper and lower yard were observed to have age appropriate outdoor toys and equipment that were in good working condition. Children have access to water both indoors and outdoor with individual water bottles, accessible water fountains and accessible filtered water stations on site. Program provides a food service that includes snack only. LPA observed cafeteria's kitchen to be clean and maintained, to avoid any contamination.

Children are signed into program by staff. LPA observed licensing documentation to be properly posted and available for review. Emergency drills are conducted at least once every six months and are properly logged. Last emergency drill was conducted 01/18/2023.

LPA reviewed facility records that included 7 random children's records that were complete. Children's files have a record of emergency identification information on file. LPA reviewed 5 random staff members' files (whom were present during visit). Staff files were also observed to be complete. Multiple staff members on site have a current CPR certification and Mandated Reporter certification. Staff on site also have required immunizations that were made available for review.

Facility was 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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

FACILITY NAME: CLARENDON BEFORE AND AFTER SCHOOL CHILDCARE CENTER	FACILITY NUMBER: 380505027
	VISIT DATE: 04/19/2023

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. Program is providing IMS at this time. 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

Licensee 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.

No deficiencies were cited today under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with licensee, Shelley Pope.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC809 (FAS) - (06/04)

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