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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380506136
Report Date: 10/25/2024
Date Signed: 10/25/2024 02:29:05 PM


Document Has Been Signed on 10/25/2024 02:29 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:SFCCD OCEAN CAMPUS CHILD DEVELOPMENT LAB SCHOOLFACILITY NUMBER:
380506136
ADMINISTRATOR:MELISSA SERRANOFACILITY TYPE:
850
ADDRESS:50 PHELAN AVENUETELEPHONE:
(415) 239-3462
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY:66CENSUS: 21DATE:
10/25/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:02 PM
MET WITH:Melissa SerranoTIME COMPLETED:
02:40 PM
NARRATIVE
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On October 25, 2024, Licensing Program Analyst (LPA) Garcia conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with Tai Do . LPA explained the purpose of the visit and was given a tour of the facility.
Present in facility are 21 children, with 4 staff members.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

LPA contacted the staff members who might be aware of the exceedances in the facility and to indicate which fixtures are affected. Unfortunately, none of the staff members can verify the affected fixtures and it is unknown which fixtures in the facility got tested and have exceedances. Based on LPA record review and staff interview, the Bungalow #213 and #212 were built in 2016. The department received the ALE report from the Vendor on October 3, 2024. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and there signs indicating that the water fountain/kitchen fixture is not for drinking and or currently out of order on some fixtures. Per results, the affected fixtures are fixture F(90) and fixture Q(5.5), it is unknown at this time if they are drinking fountains, hand washing sinks or kitchen sinks used for food preparation.

LPA contacted the site coordinator, Melissa Serrano and Department Chair, Rosario Villasana to get more information on the recent lead water testing results and locations of the fixtures. LPA was unable to reach both parties and LPA left a voicemail and call back number.

* See next page for deficiencies cited today and will also be cleared on the same day.

This report was reviewed and signed by Classified Staff, Akiyo Mineo-Aldis.

This notice of Site visit was provided to the Director and must remain posted for 30 days.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2024
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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Document Has Been Signed on 10/25/2024 02:29 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: SFCCD OCEAN CAMPUS CHILD DEVELOPMENT LAB SCHOOL
FACILITY NUMBER: 380506136

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
11/25/2024
Section Cited

101700.3

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101700.3 California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement was not met as evidenced by:
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The facility has two affected fixtures, F(90) and Q(5.5) which still have unknown locations. LPA explained the next steps to correct the defeciency such as removal or replacement and retesting.
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Based on results received from the certified water samplers, the facility exceeded 5.4 ppb of lead in their water source. This poses a potential health, safety, or personal rights risk to persons in care.
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The facility will update LPA on the locations of the affected fixtures and correct the deficiency by set due date.

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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 OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 10/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/25/2024
LIC809 (FAS) - (06/04)
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