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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001604
Report Date: 04/09/2024
Date Signed: 04/09/2024 03:32:26 PM


Document Has Been Signed on 04/09/2024 03:32 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:STAR OF THE SEA PRESCHOOLFACILITY NUMBER:
384001604
ADMINISTRATOR:VICKI CURRIERFACILITY TYPE:
850
ADDRESS:360 NINTH AVENUETELEPHONE:
(415) 221-7449
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY:30CENSUS: 10DATE:
04/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
12:58 PM
MET WITH:Mary SorensonTIME COMPLETED:
03:45 PM
NARRATIVE
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On April 09, 2024, at approximately 12.48pm, Licensing Program Analyst (LPA) Tso made an unannounced required visit to the child care center listed above. The LPA was granted entry by the Site Supervisor , Mary Sorenson. The Site Supervisor was informed of the reason for today's visit by the LPA. Present in the center included 3 staff members and 10 preschool-aged children during napping time. All individuals listed on the facility’s roster have been granted permission to work or be present in a childcare center. The center is operating within its capacity and in accordance with the required ratio of staff to children. The facility staff-to-child ratios are met. Hours of operation are Monday- Friday, 8:00 am- 5:30 pm.

LPA assessed the Center for Health and Safety Hazards with the Site Supervisor. Per Site Supervisor, there are no changes to the existing physical plant. The facility maintains a record of sign-in/out for children, and all parent signatures were accounted for and matched the number of children present. The children’s 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 at the facility. According to the Site Supervisor, 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 (not tested as in napping time, fully charged fire extinguisher, and First Aid kit. Designated cubbies are available for children to store their belongings. There is sufficient sleeping equipment and cots for each child, and all mats and bedding are kept in the appropriate location.

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.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man TsoTELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
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 04/09/2024 03:32 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: STAR OF THE SEA PRESCHOOL

FACILITY NUMBER: 384001604

DEFICIENCY INFORMATION FOR THIS PAGE:

VISIT DATE: 04/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based upon record review, the facility did not test for lead, and/or upload the test result to the designated webpage. LPA checked the designed webpage on 4/8/2024, no record was found, which poses / posed a potential health, safety, or personal rights risk to the persons in care.
POC Due Date: 05/09/2024
Plan of Correction
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Site Supervisor will have water outlets tested for lead contamination by the due date: 05/09/2024.
Proof of correction will be submitted to the department via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man TsoTELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:
DATE: 04/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/09/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: STAR OF THE SEA PRESCHOOL
FACILITY NUMBER: 384001604
VISIT DATE: 04/09/2024
NARRATIVE
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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. Multiple staff members were observed to have valid CPR/First Aid 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 most recent emergency drill was held on March 25, 2024.

LPA discussed the safe sleep regulations with the Site Supervisor 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 Site Supervisor 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 Site Supervisor 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.

The 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 Site Supervisor 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.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man TsoTELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
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: STAR OF THE SEA PRESCHOOL
FACILITY NUMBER: 384001604
VISIT DATE: 04/09/2024
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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 referred the Site Supervisor to the Department website for lead: Lead Toxicity Prevention and Water Testing Information. LPA searched on the webpage of Child Care Center Lead Sampling and Reporting Tool on 4/8/2024, no record was found. Type B deficiency citation was issued. (Please refer to LIC809D).

The Site Supervisor 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 Site Supervisor was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare. LPA reminded the Site Supervisor to arrange the teachers to attend the training.

The Site Supervisor 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.

Please refer to LIC 809D for today’s citation. A copy of today’s report and the facility’s appeal rights were discussed and given to the Site Supervisor. The Notice of Site Visit was given to the Site Supervisor and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with the Site Supervisor, Mary Sorenson.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Man TsoTELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:

DATE: 04/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/09/2024
LIC809 (FAS) - (06/04)
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