384001017-9-11-2025-05-CC-MZAA-DLEPW8-20250911114019

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001017
Report Date: 09/11/2025
Date Signed: 09/11/2025 11:40:27 AM

Document Has Been Signed on 09/11/2025 11:40 AM - 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	MISSION HEAD START-BERNAL DWELLINGS CHILDCARE CTR.		FACILITY NUMBER:	384001017
ADMINISTRATOR/ DIRECTOR:	SHALEK L. CHAPPILL		FACILITY TYPE:	850
ADDRESS:	3125 - 3141 26TH STREET		TELEPHONE:	(415) 826-1653
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 34	DATE:	09/11/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Director, Maria Villalobos		TIME VISIT/ INSPECTION COMPLETED:	12:10 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 September 11, 2025, at approximately 9:30AM, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA met with the director, Maria Villalobos, and explained the purpose of the visit. Mission Head Start – Bernal Dwellings Child Care Center is a preschool age program. The preschool program operates in three classrooms, Quetzal Room (3 yrs to 5 yrs), Mariposas Room (18 months to 3 yrs), and Estrellita Room (18 months to 3 yrs ). Hours of operation are Monday through Friday 8:00am to 5:00pm. Present during LPA's visit was the director, 34 preschool age children and 9 teachers. Program is operating within capacity limits and ratio during LPA's visit. All staff present have fingerprints and background check on file. LPA inspected facility, indoors and outdoors, for health and safety hazards. Classroom includes a variety of toys and materials that were in good condition. LPA observed classroom to have age-appropriate furniture, equipment, and materials. LPA observed cleaning materials to be stored in high cabinets, inaccessible to children in care. Per director, children nap while they are in preschool. LPA observed children’s cots inside the classrooms. Each cot was observed to have a name tag for each individual child. Per director, cots are wiped down weekly. Per director, the child care center provides the sheets and blankets. Per director, sheets and blankets are washed weekly or daily. The childcare center is equipped with a fully charged fire extinguisher and first aid kit. LPA observed Carbon monoxide detectors and smoke detectors in the facility. Carbon monoxide detector was tested during visit and was observed to be working. LPA was unable to test smoke alarm, due to alarm being wired with the entire building. Storage for children's belongings is inside the classroom. Children's cubbies are labeled with children's individual pictures on it. LPA did not observe any accessible poisons or chemicals in the classrooms. (Continue Report on Page 2...)

Marie Rodriguez
Melissa Zaragoza
	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MISSION HEAD START-BERNAL DWELLINGS CHILDCARE CTR.	FACILITY NUMBER: 384001017
	VISIT DATE: 09/11/2025

NARRATIVE

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There are 2 bathrooms inside the childcare center children can use. Bathrooms for children were observed to be clean. First bathroom has 2 toilets, and 2 sinks. The second bathroom has 3 toilets, and 3 sinks. The sinks and toilet were in working condition. The bathroom was equipped with appropriate sanitation products. LPA observed bathrooms to have trash can bins with a tight fitted lid. Classrooms were observed to have changing tables. Per director, the childcare center provides diapers and wipes. LPA observed no cleaning solutions, poisons, and other hazardous materials accessible to children in the bathroom.

The program provides a food service. Per director, childcare center provides breakfast, lunch, and snack. Per director, they have a contract with Cheffables, and food is delivered daily. Per director, food is heated up in the kitchenette area. LPA observed kitchenettes area to be clean and maintained. Site director is aware of children enrolled, with allergies or dietary restrictions.

Outdoor area is entirely enclosed and fenced. LPA observed outdoor play area to have shade. LPA observed a play area to have cement and cushion flooring. LPA observed toys and material to be in good condition. Per director children drink water in the class with cups. LPA observed water pitchers in classrooms.

Program uses a form and an app for parents to sign in and out for their sign in/sign out system. Children were properly signed in during LPAs’ visit. LPA observed licensing posters and required documents to be properly posted. The program’s last disaster drills was conducted on 08/04/2025.

LPA reviewed facility staff records. LPA reviewed children facility records which were complete and had all required documents. Children's records have emergency information on file. All staff on site have a current CPR/First Aid certification and mandated reporter certification. Staff records also include required immunizations that were made available for review.

Director was reminded all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

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SUPERVISOR'S NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: MISSION HEAD START-BERNAL DWELLINGS CHILDCARE CTR.	FACILITY NUMBER: 384001017
	VISIT DATE: 09/11/2025

NARRATIVE

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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.

The childcare center was licensed tested for lead water on 06/23/2025, and results complied.

LPA's discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed 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.

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/.

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.

There are no deficiencies cited today.

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

Exit interview conducted and report was reviewed with the director, Maria Villalobos.

SUPERVISOR'S NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 09/11/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/11/2025

LIC809 (FAS) - (06/04)

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