384000093-4-29-2025-05-CC-BVAN-DG823J-20250429170226

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384000093
Report Date: 04/29/2025
Date Signed: 04/29/2025 05:02:43 PM

Document Has Been Signed on 04/29/2025 05:02 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:	LITTLE STAR PRESCHOOL "TOO"		FACILITY NUMBER:	384000093
ADMINISTRATOR/ DIRECTOR:	HENDERSON, NIKITA		FACILITY TYPE:	850
ADDRESS:	1105 QUINTARA STREET		TELEPHONE:	(415) 731-7933
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY: 104	TOTAL ENROLLED CHILDREN: 78	CENSUS: 62	DATE:	04/29/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:55 PM
MET WITH:	Derrick Moy and Alycia Moy		TIME VISIT/ INSPECTION COMPLETED:	05:10 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 29, 2025, Licensing Program Analyst (LPA) Van conducted an unannounced annual inspection and met with the center Administrator, Derrick Moy. The purpose of the inspection was explained, and the Administrator granted LPA entry to the facility. Eight teachers and three aides supervised 62 preschool children at the time of the visit. The facility complies with the staff-to-child ratio today. The days and operations hours are Monday through Friday from 7:30 a.m. to 5:30 p.m. The Director, Alycia Moy, arrived during the inspection. All staff members present during the inspection had their criminal record clearances verified through the CDSS Guardian Background Check System and were found to have an eligible clearance status. LPA and the Director toured and inspected the physical plant to identify potential health and safety hazards. The facility is well-maintained and has proper heating, lighting, and ventilation. The center has manual signing in and out. Upon review, the record showed that all parents' signatures matched and accounted for the number of children present. The preschool program operates in two large classrooms, each of which is divided into three to four small pods. All classrooms are well-stocked with age-appropriate toys and educational materials, and the furniture is sturdy and in good condition. Additionally, the facility features a centralized combination smoke alarm, multiple carbon monoxide detectors, and a fully charged fire extinguisher. Continued on page 2.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: LITTLE STAR PRESCHOOL "TOO"	FACILITY NUMBER: 384000093
	VISIT DATE: 04/29/2025

NARRATIVE

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All hazardous materials, including cleaning solutions and poisons, are kept out of children's reach. Sleeping cots are stored appropriately. According to the Director, the family provides sleeping equipment such as blankets and pillows, which are washed weekly by the families.

LPA noted that each child has their own cubby. All emergency supplies are locked up securely. Medications are stored in the children's classroom and are kept in their original containers with consent from parents. First aid supplies are fully stocked and readily available for the children's use.

All children's toilets and handwashing sinks are in good working condition and have proper sanitation. There is a separate bathroom for staff use on the premises. LPA observed no bodies of water on the premises.

The facility presently has an outdoor waiver that allows 59 children to utilize the outdoors at one time; a rotating schedule is required due to the center's 104 capacity. The outdoor play area is kept clean and free of debris. It is also completely fenced, tidy, and in good repair. All play structures, such as climbing and sliding, have soft rubber cushions underneath to prevent accidental falls. The Director stated that the sandboxes are inspected daily before children's usage. The LPA reminded the Director that drinking water should be available and freely accessible.

According to the Director, the center provides children with lunch. Lunch is catered by a third-party vendor called 3-Stars Restaurant. Per the Director, the children bring their water bottles from home. The facility has a water filtration system for children to refill their bottles indoors and outdoors. All storage containers for solid waste within the Center have proper, tight-fitting covers.

All the required postings were observed, including the facility License, Notification of Parent Rights, Personal Rights, Car Seat Law, Emergency Disaster Plan, waiver, and Daily schedule activities.
Continued page 3.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025

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: LITTLE STAR PRESCHOOL "TOO"	FACILITY NUMBER: 384000093
	VISIT DATE: 04/29/2025

NARRATIVE

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Random children's and personnel records were reviewed during the inspection. The review showed that the facility has complete records for each child, including immunizations, admission agreements, emergency contacts, and personal rights. Staff records indicate that all staff members or individuals requiring caregiver background checks have received criminal record and child abuse index clearances or exemptions. All staff members hold valid CPR certifications and have up-to-date mandated reporter training.

The Director stated that the Center conducts fire and earthquake drills monthly; the last drills were conducted on 4/29/2025.

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.

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.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025

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: LITTLE STAR PRESCHOOL "TOO"	FACILITY NUMBER: 384000093
	VISIT DATE: 04/29/2025

NARRATIVE

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Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.

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.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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 website: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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.

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

The exit interview was conducted, and the report was reviewed with the Director, Alycia Moy.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 04/29/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/29/2025

LIC809 (FAS) - (06/04)

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