384001312-10-30-2023-05-CC-CMOK-CX4SSZ-20231030140843

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001312
Report Date: 10/30/2023
Date Signed: 10/30/2023 02:09:19 PM

Document Has Been Signed on 10/30/2023 02:09 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:	SHALOM SCHOOL		FACILITY NUMBER:	384001312
ADMINISTRATOR:	HINDA LINGAR		FACILITY TYPE:	850
ADDRESS:	862 28TH AVENUE		TELEPHONE:	(415) 831-8399
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94121
CAPACITY:	36	CENSUS: 19	DATE:	10/30/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Ella Kasminskaya & Hinda Langer		TIME COMPLETED:	02:40 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	Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Site Director, Ella Kasminskaya, and the owner, Hinda Langer and explained the purpose of the inspection to them. 19 children including 11 toddlers & 8 preschoolers with 4 staff present. The facility was a combination center with Preschool and Toddler programs. The operation hours were Monday to Friday from 8:30 AM to 5:15 PM. The preschool program was run in 2 separate classrooms (Mitzvah Mavens - 4 yrs to 5 yrs old, & Torah Tots - from 3 yrs old and up) on the upper level, and the toddler program (18 months to 36 months) was run in a classroom on the ground level. The indoor areas were inspected today for health and safety hazards. The facility was clean and in order. The room temperature and lighting were adequate. No apparent hazards were observed. There were boy's and girl's bathrooms on the ground floor. The boy's bathroom was closed for maintenance during the inspection. There was a bathroom in the toddler room on the ground floor with 1 toilet and 1 sink. The girl's bathroom has two toilets and two sinks, and the boy's bathroom has 2 urinals, 1 toilet, and 2 sinks. There was no hot water in all the children's sinks. A separate staff bathroom is available for staff in the office downstairs. Sick children will isolated in the director's office. There were plenty of age-appropriate toys, books, learning materials, and children's furniture available for children indoors. Drinking water was served in pitchers with cups. The children also brought their water cups to school if they liked. All electrical outlets were covered. The children's bathrooms were clean and in order. All lower sink cabinets were either latched or free of harmful objects. Cots were available for napping. The children's bedding was stored in separate bags with the children's names. The parents took the bedding home for washing every Friday, The facility provided AM/PM snacks, lunch & dinner to the children daily. The food preparation area was inspected during the inspection. The outdoor area on site was observed to be in good condition. The outdoor play areas were completely fenced. There were plenty of age-appropriate outdoor toys, ride-on toys, slides, and playhouses available for the children. The facility installed soft cushioning on the entire ground to prevent injury. The facility also installed a gate at the stairway to prevent children's access to the off-limit area in the yard. The facility has conducted the fire drill monthly and logged. Per the licensee, there were no children on special medication. LPA reviewed the children's and staff files and obtained a copy of the current children's roster from the licensee during the inspection. The facility used an electronic sign-in/out system that was called Bright Wheel. LPA checked the sign-in/out system during the inspection. At least a staff had current CPR/First Aid training available for review during the inspection. continued on LIC 809C

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

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: SHALOM SCHOOL	FACILITY NUMBER: 384001312
	VISIT DATE: 10/30/2023

NARRATIVE

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Criminal Record Clearance - licensee 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.

Lead Testing – CHILD CARE CENTERS 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 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four For the following scenarios use the below un-bolded language: • CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES, or • CCC COMPLETED SAMPLING BUT THE TEST RESULTS ARE NOT YET AVAILABLE, or • CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE, or • CCC TESTING DEADLINE HAS NOT PAST LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Safe Sleep - LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

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: SHALOM SCHOOL	FACILITY NUMBER: 384001312
	VISIT DATE: 10/30/2023

NARRATIVE

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Incidental Medical Services (IMS) - 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-carecenters/.

MyChildCarePlan.org – Licensee 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.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

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.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/30/2023

LIC809 (FAS) - (06/04)

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