384002291-4-5-2024-05-CC-JTSE-D42VEB-20240405162203

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002291
Report Date: 04/05/2024
Date Signed: 04/05/2024 04:22:18 PM

Document Has Been Signed on 04/05/2024 04:22 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:	ALPHA KIDS ACADEMY, LLC		FACILITY NUMBER:	384002291
ADMINISTRATOR:	RACHAEL ROCHA,DIR		FACILITY TYPE:	850
ADDRESS:	175 JUNIPERO SERRA BLVD		TELEPHONE:	(415) 664-8080
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94127
CAPACITY:	53	CENSUS: 37	DATE:	04/05/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Licensee, Natella Shtern		TIME COMPLETED:	04:35 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 4/5/2024, at approximately 2:15PM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Licensee, Natella Shtern (L1). LPA explained the purpose of the visit. Present during the visit were seven teachers and 37 preschool age children. The facility is in compliance with staffing and ratio requirements on this day. The facility’s current operating hours are from 7:30AM to 5:30PM. LPA inspected the facility for any health or safety hazards. LPA observed the facility to be in clean and orderly condition. There are smoke detectors and a fire alarm system running throughout the facility. There is a carbon monoxide detector present. There is a fully charged fire extinguisher present. Electrical outlets are covered or obstructed by furniture when not in use. All off-limits areas are secured by childproof gates or doorknob covers. The facility operates in four classrooms: Explorers (2-3 years), Adventurers (3-3.5 years), Navigators (3.5-4 years), and Captains (4-4.5 years). LPA observed age-appropriate toys and learning materials to be present in all classrooms. Furniture is age-appropriate and free of rough or sharp edges. Waste bins are fitted with tight-fitting lids. The facility provides mats for children to nap on. Children bring bedding from home and take it back once a week for cleaning. Children bring lunch from home. The facility provides dry snacks for children in care. Water bottles are brought from home and refilled at the facility. Water service is provided from a vendor and is distributed via a water dispenser. Medication is stored centrally and out of reach of children. Per L1, there are no firearms or weapons stored in the facility. Continued on Page Two

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

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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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: ALPHA KIDS ACADEMY, LLC	FACILITY NUMBER: 384002291
	VISIT DATE: 04/05/2024

NARRATIVE

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LPA observed the outdoor play area to be free of debris and other loose articles. There are age-appropriate toys and equipment present for children. There is a play structure that has resilient padding in the form of mats. The facility has an outdoor rotation waiver allowing for a maximum of 32 children outdoors at a time. During the visit, LPA found that the facility was in compliance with the waiver. There are no pools present in the facility.

LPA reviewed six staff files, six children’s files, and facility records. There is at least one teacher present with valid and current First Aid/CPR certification. All staff members have current Mandated Reporter Training. All adults present in the facility have acquired criminal background clearance and are associated to the facility. All children’s files were observed to be complete. LPA observed all required postings to be visible and accessible for review. The facility has not conducted lead water testing due to not using any fixtures for drinking, food preparation, or consumption of any kind. The facility has communicated this to the Regional Office past the due date of 1/1/2023 LPA discussed attestation requirements with L1 and obtained relevant information regarding water services in the facility. See LIC809-D for deficiency cited today.

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.

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.

Continued on Page Three

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

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: ALPHA KIDS ACADEMY, LLC	FACILITY NUMBER: 384002291
	VISIT DATE: 04/05/2024

NARRATIVE

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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 licensee to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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/.

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.

See LIC809-D for deficiency cited today regarding lead water testing. Appeal rights were provided to L1.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the licensee, Natella Shtern.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 04/05/2024 04:22 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: ALPHA KIDS ACADEMY, LLC	FACILITY NUMBER: 384002291
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/05/2024

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
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above which posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 05/03/2024
	Plan of Correction
1 2 3 4	Licensee shall provide LPA with information regarding the facility's water services. Licensee shall provide to LPA a previous attestation stating that the facility does not use any fixtures in the facility for drinking, food preparation, or consumption.

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: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 04/05/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/05/2024

LIC809 (FAS) - (06/04)

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