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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002201
Report Date: 06/29/2023
Date Signed: 06/29/2023 10:28:30 AM


Document Has Been Signed on 06/29/2023 10:28 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 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: 27DATE:
06/29/2023
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:32 AM
MET WITH:La Rhonda MartinTIME COMPLETED:
10:30 AM
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On 6/29/23 at approximately 9:15AM, Licensing Program Analyst (LPA) Garcia made a scheduled case management visit to the child day care facility listed above. The purpose of the visit is to inspect room 1 and 4 for room changes. Per director, room 1 is being utilized by their preschoolers (3-4 year old) and have 12 kids enrolled in that class. The changes will be that room 1 will be utilized for 2 year olds and room 4 will be for the preschoolers. Since the capacity remains the same and is currently being utilized, the fire clearance and measurements are not required.

During the visit, there were a total of 27 children in all four day care rooms. There were 9 children present in room 1 and 7 children present in room 7 with at least two teachers in each classroom.

During today's visit the facility was checked for any health and safety concerns. LPA observed that there is a centralized fire alarm, a smoke and carbon monoxide detector, and a fully charged fire extinguisher in the classroom. Age appropriate toys, furniture, and equipment are available for children. There is a storage area for children's personal items. LPA also observed that there are pictures of students enrolled in the whole school with allergies posted in each classroom for reference.

LPA approved the room change effective on 6/29/23.

Today's report was reviewed and discussed with the Director, La Rhonda Martin. A copy of today’s report and the “Notice of Site Visit” were given.

No deficiencies were cited today under the California Code of Regulations, Title 22, Division 22
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/29/2023
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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