<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002725
Report Date: 03/01/2024
Date Signed: 03/01/2024 02:12:34 PM


Document Has Been Signed on 03/01/2024 02:12 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:KAI MING RAINBOW INFANT/TODDLER CENTERFACILITY NUMBER:
384002725
ADMINISTRATOR:LEI, IOKCHANFACILITY TYPE:
830
ADDRESS:799 PACIFIC AVENUETELEPHONE:
(415) 982-4777
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94133
CAPACITY:22CENSUS: 21DATE:
03/01/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Iokchan LeiTIME COMPLETED:
02:30 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 March 01, 2024 at approximately 12:00pm, Licensing Program Analyst (LPA) Ly conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with Site Manager, Iokchan Lei. The purpose of the inspection was explained.

Facility is an infant/toddler facility. Present during today's visit were 4 staff caring for 9 infants and 4 other staff caring 12 toddlers.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

The facility received the ALE report from the Vendor on 06/14/2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5ppb. The facility was proactive putting signs indicating that the water outlets and sinks are "not for drinking" and for "hand washing only." The facility took action to contact the facility's management to repair and replace the fixtures. Per Site Manager, the affected fixture B located in the toddler classroom with the lead test result 8.5 is currently being used for hand washing only. Fixture D with the lead test result 6.4 is also being used for hand washing only.

Facility with lead test results higher than 5.5ppb poses a potential health and safety risks to persons in care. Type B violation is being issued on this day in accordance with WD101700.3. See LIC 809D for deficiency cited.

During today's visit, LPA obtained the copies of the Facility Sketch (LIC999), Analytical Report dated 06/13/2022.

A copy of this report and appeal rights were discussed and left with Site Manager whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. Notice to remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 2


Document Has Been Signed on 03/01/2024 02:12 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: KAI MING RAINBOW INFANT/TODDLER CENTER
FACILITY NUMBER: 384002725

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/01/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/01/2024
Section Cited

101700.3(b)(1)

1
2
3
4
5
6
7
101700.3 California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The facility has put up signs at affected fixtures indicating that the water outlets are not for drinking and are strictly for hand washing only.
8
9
10
11
12
13
14
Based on observation, interview and record review, the facility did not ensure to maintain a level to be under 5 ppb at fixtures B and D. This poses a potential health, safety or personal rights risk to persons in care.
8
9
10
11
12
13
14
Facility must have running water for Faucet B and D until fixtures are retested with a certified water sampler by 03/01/2024.

Once retest is done, faciity representative will submit retest results to the department.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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: Winnie LyTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/01/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/01/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2