384002310-3-21-2024-05-CC-CMOK-D3KS4B-20240321133228

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002310
Report Date: 03/21/2024
Date Signed: 03/21/2024 01:36:45 PM

Document Has Been Signed on 03/21/2024 01:36 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:	LEVY, SUMI LEE		FACILITY NUMBER:	384002310
ADMINISTRATOR:	LEVY, SUMI LEE		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 846-8119
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94121
CAPACITY:	14	CENSUS: 6	DATE:	03/21/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Sumi Lee Levy		TIME COMPLETED:	02:00 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	Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the licensee, Sumi Lee Levy, and a helper who has fingerprint clearance. LPA explained the purpose of the inspection to her. 6 preschoolers were playing in the backyard upon LPA's arrival. The facility is a Korean Immersion facility. The daycare's entrance is on the left side of the garage. The facility is called "DOREMI KIDS", and the operation hours are Monday to Friday from 8:30 AM to 5:30 PM. The licensee rents and lives with her 2 minor children in this 2-stories single-family house that has two bedrooms, 1 bath, a living room, a dining room, and a Kitchen on the second floor; one bedroom, one bath, a playroom, a backyard and a garage on the ground level. The daycare areas are on the ground level including two playrooms, a bathroom, and a backyard. The off-limit areas are the entire upper level and a garage. LPA inspected the facility for health and safety hazards. The facility was clean and in order, the temperature and lighting were adequate and toxins and harmful objects were made inaccessible to the children There was a fully charged 2A10BC fire extinguisher, working smoke and carbon monoxide detectors, and first aid supplies available in the facility. There were the right amount of hooks for the children to hang their personal belongings in the entrance hallway. There were plenty of age-appropriate toys, books, learning materials, and children's furniture that were in good condition and repaired, The children's bathroom was clean. All the toxins and harmful objects were made inaccessible to the children. There was a small food preparation area. The lower sink cabinet in the food preparation area was free of harmful objects. All the electrical outlets were covered. Mats were used for napping. The outdoor play area was completely fenced. LPA didn't observe any harmful objects in the yard. There were some outdoor toys, slide structures, ride-on-toys, and play structures with soft cushioning underneath to prevent injury, The facility had no guns, weapons, or pets. The facility provides Breakfast, & PM snacks to the children only. The children have brought their lunch to school daily. Their lunches are kept in their bags in the children's storage area. Per Sumi, there were no children on special medication. LPA reviewed the staff and children files and obtained a copy of the current children's roster from the facility during the inspection. The helpers had current CPR/FIRST AID training, which will expire in 7/2024. The facility has conducted the disaster drills bi-weekly. continues in LIC809C

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LEVY, SUMI LEE	FACILITY NUMBER: 384002310
	VISIT DATE: 03/21/2024

NARRATIVE

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Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in home, 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 licensed Family Child Care Home. 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.

Safe Sleep - LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: LEVY, SUMI LEE	FACILITY NUMBER: 384002310
	VISIT DATE: 03/21/2024

NARRATIVE

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MyChildCarePlan.org – 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.

Megan’s Law - During the exit interview, Sumi Lee Levy, confirmed that there are no Registered Sex Offenders living in the facility and LPA completed the RSO profile in FAS.

Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, Sumi Lee Levy.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

LIC809 (FAS) - (06/04)

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