384003038-7-21-2022-05-CC-LGOZ-CGJRCD-20220721125409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384003038
Report Date: 07/21/2022
Date Signed: 07/21/2022 12:54:23 PM

Document Has Been Signed on 07/21/2022 12:54 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SWEET PEAS PRESCHOOL		FACILITY NUMBER:	384003038
ADMINISTRATOR:	DIONNE, SAMANTHA		FACILITY TYPE:	850
ADDRESS:	1647 VALENCIA STREET		TELEPHONE:	(415) 637-0796
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY:	40	CENSUS: 17	DATE:	07/21/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Samantha Dionne, Angelica Leblanc		TIME COMPLETED:	01:05 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 7/21/2022 at 8:35AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Teachers, Angelica LeBlanc. Purpose of the inspection was explained and was for an unannounced; annual random inspection. Present in facility were four staff supervising 17 children. Site director, Samantha Dionne arrived during inspection. All children had been properly signed in. Preschool program utilizes two large classrooms and one outdoor play area. Hours of operation are Monday- Friday 8:00am- 5:00pm. Program operates year-around. LPA inspected facility, indoors and outdoors, for health and safety hazards. At 8:45AM., the following was observed: classrooms were clean, orderly, and with age-appropriate playthings available for the children. Floor and ground surfaces were free of obstructions. Children’s furniture was in proper repair. LPA observed individual cubbies for storage of children's belongings. Facility had child size tables and several chairs for snack and activities. For napping services, stackable cots were stored next to the children bathroom. LPA reminded director to label cots with each child’s name. Per director, napping sheets are washed weekly. Children’s bathroom was reviewed during inspection. Fixtures tested were in operating condition. Bathroom had supplies were available for handwashing. Staff bathroom is located separately. Classroom was the proper temperature, with ventilation, and lighting. Trash bins and outlets are properly covered. Facility had functioning telephone service, smoke/ carbon monoxide detector combo, and two fully charged fire extinguisher; 3A:40BC. First aid kit was review during inspection. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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 07/21/2022 12:54 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: SWEET PEAS PRESCHOOL	FACILITY NUMBER: 384003038
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 07/21/2022

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
1 2 3 4	Based on interview and record review, LPA confirmed staff missing their updated mandated reporter training certification (AB1207). This poses a potential health and safety risk to children in care.
	POC Due Date: 08/12/2022
	Plan of Correction
1 2 3 4	Director will submit staff's mandated reporter training certificate prior to the due date: 8/12/2022. Proof of correction will be submitted to the Department via email.

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: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

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: SWEET PEAS PRESCHOOL	FACILITY NUMBER: 384003038
	VISIT DATE: 07/21/2022

NARRATIVE

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(Page 2)
At 9:05AM., LPA inspected the outdoor play area. Area was completely enclosed, with adequate shade available. Play structure was properly anchored. Rubber padding was installed to absorb potential falls. Pitcher of fresh water and with paper cups are accessible for the day-care children. Per director, pitcher is refilled daily from non-contained source.

At 9:10AM., Based on observations, LPA confirmed cleaning wipes in outdoor play area. Cleaning supplies were stored in off limit area by staff during inspection. Advisory Note: Technical Violation (LIC9102TV) was issued.

LPA inspected the food preparation area. Program provides snack services for children in care. Food items reviewed were current and properly stored.

At 9:30AM., LPA review the facility records including ten children's files and four personnel files. Staff files were reviewed and included: Criminal Record Statements (LIC508); Declaration to Report Suspected Child Abuse (LIC9108); Required Transcripts; and Notice of Employee Rights (LIC9052).

LPA reminded facility ensure staff's proof of required immunization are stored in the facility files.

At 9:50AM Based on interview and record review, LPA confirmed staff missing their updated mandated reporter training certification (AB1207).

Children's files reviewed and included: Health History (LIC702); Identification of Emergency Information (LIC700); Consent for Medical Treatment (LIC627); Notification of Parent’s Rights (LIC995).

Staff had their current CPR (Cardiopulmonary Resuscitation)/ First Aid certification expiring 9/2023. Per director, emergency disaster drill was conducted on 5/17/2022. LPA reminded director to log each emergency disaster drills conducted at the site.

Required posting were posted and include: Childcare License, Notification of Parents Rights (PUB393); Updated Emergency Disaster Plan (LIC610); and Child Passenger Safety Laws. LPA advised director ensure updated snack menu is posted in visible location.
(REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: SWEET PEAS PRESCHOOL	FACILITY NUMBER: 384003038
	VISIT DATE: 07/21/2022

NARRATIVE

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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 Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on today's inspection, deficiencies were observed in the areas evaluated, according the Title 22 Division 12 Ca. Code of Regulations and cited on 809C. Exit interview and plan of correction was discussed with Director, Samantha Dionne and signature of this form acknowledges receipt of these documents.

The 'Notice of Site Visit' was provided to director and must remain posted for 30 days.

This report and rights to comment were discussed. This report must be available in the facility for public review. For additional questions, facility was advised to contact the Community Care Licensing Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/21/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/21/2022

LIC809 (FAS) - (06/04)

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