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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380506509
Report Date: 09/22/2023
Date Signed: 09/22/2023 01:58:11 PM


Document Has Been Signed on 09/22/2023 01:58 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:HELEN HAWK CHILDREN'S CTR-COMPASS FAM SRVS INFANTFACILITY NUMBER:
380506509
ADMINISTRATOR:PERLA, ELIZABETHFACILITY TYPE:
830
ADDRESS:111 PAGE STREETTELEPHONE:
(415) 863-0681
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY:8CENSUS: 3DATE:
09/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Elizabeth PerlaTIME COMPLETED:
02:00 PM
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On September 22, 2023., Licensing Program Analyst (LPA) Van met with Director Elizabeth Perla for an unannounced mandatory 1-year random inspection. This is a combination Center with Infants, Preschool, and School-age programs operating in the same building. The infant program has two teachers supervising three children today. The facility staff-to-child ratios are met. Hours of operation are Monday- Friday, 8:30 am- 5:30 pm.

LPA assessed the Center for Health and Safety Hazards with the Director. The facility maintains a record of sign-in/out for infants, and all parent signatures were accounted for and matched the number of infants present. The infants' classroom environment appeared clean and organized, with appropriate heating, lighting, and ventilation. The Center also provided age-appropriate toys, furnishings, changing tables, and equipment. LPA did not observe any pools, spas, or other bodies of water, nor did they notice any bouncers, exersaucers, or similar equipment at the facility. According to the Director, no firearms or weapons are present at the Center, and all cleaning materials and potentially hazardous objects are kept out of reach of children. Personnel restrooms are separate from children, and all solid waste storage containers have tightly fitted lids. The Center also maintains a carbon monoxide detector, centralized smoke alarm, fully equipped fire extinguisher, and First Aid kit. Designated cubbies are available for children to store their belongings. The diaper changing table has at least 1" thick padding, is covered with disposable paper, and has at least 3" elevated edges. The changing tables are within arm's reach of the sink, and disposable wipes are used to clean after each usage. There is sufficient sleeping equipment and cots for each child, and all mats and bedding are kept in the appropriate location. LPA also observed that the food preparation site is clean, organized, and inaccessible to children.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/22/2023
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: HELEN HAWK CHILDREN'S CTR-COMPASS FAM SRVS INFANT
FACILITY NUMBER: 380506509
VISIT DATE: 09/22/2023
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The facility has an outdoor waiver approved by the Department that allows no more than 13 children combined in three programs at one time. LPA reviewed the waiver and reminded the Director that infants, preschoolers, and school-age children may not be commingled with any other age group while in the outdoor play area. Additionally, the group should not exceed a capacity of 13 at any time. LPA observed that the outdoor playground area is in good repair and completely fenced for supervision. The play structure is age-appropriate and in good condition, with sufficient cushioning underneath.

LPA checked the personnel and children's records at the facility. A sample of children's files was found to contain comprehensive information such as medical assessments, needs, services, feeding plans, and signed admission agreements. The staff files were also well-organized and thorough, with proof of educational credentials. Multiple staff members were observed to have valid CPR cards and vaccine proofs for Measles, Pertussis, and Influenza in their files. Additionally, the facility had posted the required documents, including the license, menus, waivers, Notification of Parental Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. The Director stated that fire and earthquake drills are conducted monthly, with the most recent fire drill being held in June 2023.

LPA discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reminded the Director 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.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: HELEN HAWK CHILDREN'S CTR-COMPASS FAM SRVS INFANT
FACILITY NUMBER: 380506509
VISIT DATE: 09/22/2023
NARRATIVE
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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 PIN 22-02-CCP. 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/.

The Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for
drinking and food preparation) for lead contamination before January 1, 2023, and then every 5 years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4
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: HELEN HAWK CHILDREN'S CTR-COMPASS FAM SRVS INFANT
FACILITY NUMBER: 380506509
VISIT DATE: 09/22/2023
NARRATIVE
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The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to be completed every two years by all staff hired a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

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/process.

During the inspection, LPA requested a new Emergency Disaster Plan (LIC 610), Designation of Responsibility (LIC 308), Personnel Report (LIC 500), and Incidental Medical Services (IMS) Plan. All requested documents will be submitted to Licensing by October 6, 2023.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Elizabeth Perla.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/22/2023
LIC809 (FAS) - (06/04)
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