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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002478
Report Date: 04/20/2022
Date Signed: 04/22/2022 02:33:55 PM


Document Has Been Signed on 04/22/2022 02:33 PM - It Cannot Be Edited

Document is an Amendment of Original Document on 04/22/2022 02:31 PM

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

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 THIS IS AN AMENDED DOCUMENT
On April 20, 2022 at 8:30 AM, Licensing Program Analyst (LPA) Cowan met with Health and Safety Director, Aeri Kim, for an unannounced annual random inspection. Present today is director, 12 staff, and 23 infants in care. Staff to child ratio was met on this day. The center operates Monday - Friday 8:00am to 6:00pm. The center has five classrooms: Pine Cones, Dew Drops, Daffodils, Sweet Pea, and Seedlings.

LPA inspected the infant day care area for health and safety hazards today. The center is clean, orderly and in good repair. There are no pools, spas or other similar bodies of water on site. Per director, there are no firearms or weapons on site. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. All furniture and equipment are clean and in good working condition. The center's furniture and equipment are age appropriate. There is a sufficient quantity of cribs, and changing tables to meet the capacity. Bedding is sent home once a week for cleaning by parents while cribs and mats are wiped down and disinfected daily. Bottles and other items provided by the parents are labeled and stored appropriately. Food and formula are provided by parents. Changing tables are within an arm’s reach of a sink. The center has a working carbon monoxide detector in each classroom. LPA observed infants were supervised by staff in the classrooms and in the napping area. All solid waste storage containers have secure lids. The outdoor play area designated for the infants and toddlers was clean and in good repair. All toys and equipment are in working condition. Per director, toys are cleaned nightly. Areas under outdoor equipment is adequately cushioned with poured rubber.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
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 04/20/2022 02:04 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: BRIGHT HORIZONS AT KANSAS STREET (INF)
FACILITY NUMBER: 384002478

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101170(d)
Criminal Record Clearance
(d) All individuals subject to criminal record review shall, be fingerprinted and sign a Criminal Record Statement (LIC 508 [Rev. 1/03]) under penalty of perjury.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on (record review, the licensee did not comply with the section cited above in [1] out of [12] staff did not have fingerprint clearance which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 04/20/2022
Plan of Correction
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Health and Safety director agrees to send staff home and not have staff member return until staff obtains fingerpirnt clearance.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/20/2022 02:04 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066


FACILITY NAME: BRIGHT HORIZONS AT KANSAS STREET (INF)
FACILITY NUMBER: 384002478

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/20/2022

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
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Based on record review, the licensee did not comply with the section cited above in [9] out of [12] Staff did not have a current Mandated Reporter Training on file ] which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/04/2022
Plan of Correction
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Health and Safety Director agrees to have all staff obtain certification by 5-4-22. Director agrees to email certifications to LPA by the above date.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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 LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/20/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/20/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BRIGHT HORIZONS AT KANSAS STREET (INF)
FACILITY NUMBER: 384002478
VISIT DATE: 04/20/2022
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At 9:55 AM, Staff files were reviewed. LPA observed that all children's files are complete with required Licensing documents. All staff have Education units on file for teachers. At least one staff member on site has current CPR/First Aid certification. At 11:31 AM, LPA observed that one staff member did not have Criminal Record Clearance. This is an immediate risk to children in care. A type A violation is issued this day. All required posting are posted for review.

LPA discussed the availability of water for children inside as well as on the playground. LPA discussed Safe Sleep, and Mandated reporter Training.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BRIGHT HORIZONS AT KANSAS STREET (INF)
FACILITY NUMBER: 384002478
VISIT DATE: 04/20/2022
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LPA discussed the safe sleep regulations with 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 Health and Safety 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.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

>See next page for deficiencies

Exit interview conducted and report was reviewed with health and safety director, Aeri Kim.

This report must be available in the facility for public review. Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

The copy of this report is reviewed and provided to the health and safety director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/20/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/20/2022
LIC809 (FAS) - (06/04)
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