384002202-10-10-2023-05-CC-BVAN-CWGRG7-20231010130018

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002202
Report Date: 10/10/2023
Date Signed: 10/10/2023 01:00:41 PM

Document Has Been Signed on 10/10/2023 01:00 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 - HAYES VALLEY CDC (INFANT)		FACILITY NUMBER:	384002202
ADMINISTRATOR:	KIMBERLY WONG		FACILITY TYPE:	830
ADDRESS:	305 BUCHANAN STREET		TELEPHONE:	(415) 552-1535
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94102
CAPACITY:	18	CENSUS: 16	DATE:	10/10/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Maria Martin and Stephanie Kuyper		TIME COMPLETED:	01:00 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 October 10, 2023., Licensing Program Analyst (LPA) Van met with the lead teacher, Maria Martin, for an unannounced required annual inspection. The purpose of the inspection was explained. During the inspection, the new Site Director, Stephanie Kuyper arrived. This is an infant and toddler component Center that is licensed for a total capacity of 18, with no more than 12 toddlers and 6 infants. Today, there are 10 toddlers and 6 infants supervised by six staff and the Site Supervisor. The facility complies with the required teacher-infant ratios today. The hours of operation are Monday to Friday, 7:30 am to 5:30 pm. LPA evaluated the Center for Health and Safety Hazards along with the Director. The facility maintains a proper record of sign-in/out for infants, and all parent signatures match the number of infants present. The environment of the infants' classroom appeared clean and organized, with appropriate heating, lighting, and ventilation. The Center provides age-appropriate toys, furnishings, changing tables, and equipment. LPA did not observe any pools, spas, or any other bodies of water, nor did they notice any bouncers, exersaucers, or similar equipment at the facility. According to the Director, 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, fully equipped fire extinguisher, and First Aid kit. Designated cubbies are available for children to store their belongings. Continued on page 2...

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

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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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Document Has Been Signed on 10/10/2023 01:00 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: FACESSF - HAYES VALLEY CDC (INFANT)	FACILITY NUMBER: 384002202
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 10/10/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on the record review, the Center did not comply with the abovementioned section. Three out of Five staff members have not completed their Mandated reporter training, or the training has expired, which poses/posed a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 10/24/2023
	Plan of Correction
1 2 3 4	The Center/Site Director must ensure that all staff complete the Mandated Reporter Training bi-annually and are available for review during the inspection. The Site Director states she will have the staff members complete the training and send the completion to the Licensing office by October 24, 2023.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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 Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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: FACESSF - HAYES VALLEY CDC (INFANT)	FACILITY NUMBER: 384002202
	VISIT DATE: 10/10/2023

NARRATIVE

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There is a designated area where infants can rest or nap without being distracted or disturbed. The area is equipped with sufficient sleeping equipment and cots for each child, and all mats and bedding are stored in their appropriate location. As stated by the Director, the parents provide bedding and other necessary sleeping equipment. Additionally, the napping equipment and blankets are washed and cleaned weekly. LPA has reminded the Director that emergency exits must always remain clear and that cots and cribs cannot be placed in a manner that obstructs emergency exits.

Per Director, parents provide disposable diapers and wipes for their infants at the center. The facility has two designated changing tables, equipped with at least 1" thick padding and covered with disposable paper. Additionally, the changing tables are designed with at least 3" elevated edges to prevent accidents. Disposable wipes are used to clean the area after each use. The Director has been reminded that the diaper changing area and sink must be reserved for their intended use only. It is imperative that they are not used for food preparation or as a counter to store classroom activities or teacher resources.

Parents provide bottles, nipples, and other food service items for their infants, and the staff ensures that these items are sent home with the infants each day. During the observation by LPA, it was noted that the breast milk or formula provided by parents was stored appropriately in the refrigerator, and each bottle was labeled accordingly. Plastic baby water bottles or cups with lids are used to provide drinking water for the infants. The food preparation site is kept clean, organized, and inaccessible to children. Medications intended for infants are stored in a locked metal box inside the Director’s office.

The outdoor surface area appears to be well-maintained and in good condition. It's covered with soft rubber turf materials, making it a safe and comfortable space for infants to play. Age-appropriate structures were observed in the play yard, appearing sturdy and in good condition. Drinking water is also easily accessible outside through pitchers, cups, or bottles.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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: FACESSF - HAYES VALLEY CDC (INFANT)	FACILITY NUMBER: 384002202
	VISIT DATE: 10/10/2023

NARRATIVE

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LPA checked the personnel and children's records at the facility. A sample of children's files contained complete information such as medical assessments, needs, services, feeding plans, and signed admission agreements. The staff files were well-organized and thorough, with proof of educational credentials. Multiple staff members were observed to have valid CPR cards. 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 Director stated that fire and earthquake drills are conducted at least once every six months, with the most recent fire drill being held on April 18, 2023.

LPA discussed the safe sleep regulations with the Director 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 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.

LPA reminded the Director 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.

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/.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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: FACESSF - HAYES VALLEY CDC (INFANT)	FACILITY NUMBER: 384002202
	VISIT DATE: 10/10/2023

NARRATIVE

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The 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.

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 verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

The Director 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 Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The 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.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/10/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

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: FACESSF - HAYES VALLEY CDC (INFANT)	FACILITY NUMBER: 384002202
	VISIT DATE: 10/10/2023

NARRATIVE

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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.

During the inspection, LPA requested a new Emergency Disaster Plan (LIC 610), Designation of Responsibility (LIC 308), Personnel Report (LIC 500), and New Site Director paperwork for Stephanie Kuyper. All requested documents will be submitted to Licensing by October 24, 2023.

See LIC 809D for the deficiency cited today.

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

An exit interview, report, and appeal rights were reviewed with the Director, Stephanie Kuyper.

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

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2023

LIC809 (FAS) - (06/04)

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