<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002201
Report Date: 06/22/2023
Date Signed: 06/22/2023 02:57:34 PM


Document Has Been Signed on 06/22/2023 02:57 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:FACESSF - MASONIC PRESCHOOLFACILITY NUMBER:
384002201
ADMINISTRATOR:KAREN LAMFACILITY TYPE:
850
ADDRESS:1101 MASONIC AVENUETELEPHONE:
(415) 355-0210
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94117
CAPACITY:71CENSUS: 26DATE:
06/22/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:LaRhonda MartinTIME COMPLETED:
03:13 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 June 22, 2023 at 2:00 PM, Licensing Program Analyst (LPA) April Cowan conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with the director, LaRhonda Martin. The purpose of the inspection was explained.

Present director, 11 staff, and 26 children in care. During inspection, site director explains that the facility has retested faucets and received a clearance. Facility retested faucets on May 4, 2023 and received results which were posted on May 18, 2023.

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/22/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 1