384002662-2-20-2024-05-CC-LGOZ-D2MSER-20240220124910

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002662
Report Date: 02/20/2024
Date Signed: 02/20/2024 12:49:21 PM

Document Has Been Signed on 02/20/2024 12:49 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:	CRAYON BOX PRESCHOOL, THE		FACILITY NUMBER:	384002662
ADMINISTRATOR:	RAZO, ADRIANA		FACILITY TYPE:	850
ADDRESS:	3215 CESAR CHAVEZ		TELEPHONE:	(415) 821-9008
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	83	CENSUS: 21	DATE:	02/20/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:25 AM
MET WITH:	Maria Murillo, Adriana Razo		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 2/20/2024 at 8:25AM., Licensing Program Analyst (LPA), Luis Gomez and Staff Adriana Razo. Purpose of the inspection was explained and was for an Unannounced, Annual Random inspection. Facility is licensed to operate a preschool program. The site’s director, Maria Murillo arrived during inspection. Present was the director and 5 staff supervising 21 children. The children present had been properly signed in by authorized representee. The Department has staff's criminal record clearances of file. The childcare program utilizes three classrooms: Red Room, 4-5 year olds; Yellow Room, 2 years old; and Green Room, 3 years old. Facility also utilizes the Art Room, Dramatic Playroom, Science Room, Reading Room, Yoga Room and one Outdoor Play Area. Per director, Purple classroom is not currently in use. LPA inspected facility for health and safety hazards. At 8:35AM., LPA observed the following: Classrooms were clean with age-appropriate materials available for the children. Floor and ground surfaces were safe and clear of any obstructions or possible hazards. Each classroom was equipped with tables and chairs, scaled to the size of the children. Cubbies and individual storage of children's belongings are available in each classroom. Accessible furniture inspected was free of any sharp corners or splinters. The children’s bathrooms were clean, with toilets (6) and hand washing fixtures (7) in operating condition. Per Director, the staff bathroom is located separately. For nap services, LPA observed foldable mat stored in facility hallway. The mats inspected were made from a cleanable plastic material. Per director, napping supplies are taken home weekly by families to be washed. The facility had adequate ventilation and was a comfortable temperature. The classrooms had sufficient lighting for the children. Facility's disinfectants, cleaning solutions, poisons and other items that could pose a danger, had been stored in the off-limit areas. Facility had a smoke/ carbon monoxide combination detector; telephone service; and fire extinguishers: 2A:10:BC. Per director, the local fire authority makes yearly visits to the center. LPA reviewed the facility’s first aid kit during inspection. (REFER TO 809c, FOR CONT.)

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2024

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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Document Has Been Signed on 02/20/2024 12:49 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: CRAYON BOX PRESCHOOL, THE	FACILITY NUMBER: 384002662
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/20/2024

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	At 9:50AM., Based on record review, LPA confirmed testing for lead contamination level of facility’s drinking water was conducted after the 1/1/2023 deadline. This poses a potential health and safety risk to children in care.
	POC Due Date: 02/21/2024
	Plan of Correction
1 2 3 4	On 5/13/2023, facility conducted testing of lead contamination levels of facility's drinking water. Drinking water test results have been posted on State's Waterboard Database, with fixtures not showing lead exceedance. Deficiency was cleared during inspection.

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: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2024

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: CRAYON BOX PRESCHOOL, THE	FACILITY NUMBER: 384002662
	VISIT DATE: 02/20/2024

NARRATIVE

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(Page 2)
At 9:15AM., LPA inspected the outdoor play area. The outdoor area was completely enclosed with an absorbent material installed on the ground surface for added safety. The playthings, tricycles, and equipment inspected were in good repair. Per director, water services are provided inside and outside, with refillable cups.

At 9:20AM., Based on observations, LPA confirmed excessive leaves on ground in the outdoor play area. Advisory Note: Technical Violation (LIC9102TV) was issued.

Facility’s food preparation area/ storage was review during inspection. Area was clean, and free of any trash or rubbish. Food items inspected were current and had been properly stored.

At 9:40AM., LPA reviewed facility records including: 5 children’s files and 6 personnel files. Facility’s personnel files were reviewed and contained the: Teachers Qualifications; Notice of Employee Rights (LIC9052); and Personnel Record.

LPA reminded director to ensure staff's completed the required 'Mandated Reporter Training' Certification' (AB1207), an Proof of Immunization are stored in the facility file. Advisory Note: Technical Violation (LIC9102TV) were issued.

Facility’s children’s files were reviewed and contained the: Immunization Records, Identification and Emergency Information (LIC700); Notification of Parent’s Rights (LIC995); Personal Rights (LIC613A); and ‘Written Medical Assessments’.

At 9:50AM., Based on record review, LPA confirmed testing for lead contamination level of facility’s drinking water was conducted after the 1/1/2023 deadline.

Facility personnel have Cardiopulmonary Resuscitation / First Aid certifications, which expire on 9/2025.

The required emergency disaster drills are being conducted every six months, with last drill completed on 1/17/2024, properly logged.

LPA observed required postings and posted in each classroom and included the: Notification of Parent’s Rights (PUB394); Passenger Safety Law (PUB269); Snack Menu; and Emergency Disaster Plan (LIC610). LPA advised director to post license is visible location. (REFER TO 809c, FOR CONT.)

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2024

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: CRAYON BOX PRESCHOOL, THE	FACILITY NUMBER: 384002662
	VISIT DATE: 02/20/2024

NARRATIVE

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(Page 3)
Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed child care centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test.

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

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, an updated Plan of Operation that includes 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) 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/.

Director was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on the 809D. Exit interview and facility evaluation report was discussed with Director, Maria Murillo. Licensee's signature on this form acknowledges receipt of these documents.

This report must be made available in the facility for public review. Notice of site visit was provided and must remain posted for 30 days. Director was advised any additional questions to call office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/20/2024

LIC809 (FAS) - (06/04)

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