384004033-4-2-2024-05-CC-CMOK-D3XS9J-20240402134048

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004033
Report Date: 04/02/2024
Date Signed: 04/02/2024 01:42:50 PM

Document Has Been Signed on 04/02/2024 01:42 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:	FRIEDMAN, SHIFRA V. & PIL, MENACHEM M.		FACILITY NUMBER:	384004033
ADMINISTRATOR:	FRIEDMAN, SHIFRA V.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 756-9411
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94121
CAPACITY:	14	CENSUS: 10	DATE:	04/02/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:05 AM
MET WITH:	Menachem Mendel Pil		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 licensees, Shifra Friedman and Menachem Mendel Pil (Mendel) and 3 helpers. LPA explained the purpose of the inspection to the licensees. There were 10 children, including an infant playing at the outdoor play yard upon LPA's arrival. The name of the daycare was called " Kibbie Farm Day Care”. The operation hours were Monday to Sunday from 8:AM to 5 PM, except Saturday. The licensee rented the 2 story singly family house with 2 bedrooms, 1 and 1/2 bathroom, living room, dining room, and kitchen on the upper level. The lower level had an in-law with 2 rooms, living room, & a full bathroom, a backyard, and a garage. The daycare areas were the entire lower level and backyard except the garage and upper level. The off-limit areas were the entire upper level and a garage. LPA toured and inspected the facility for health and hazard. The facility was clean and in order. Temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the children. Cubbies were available for the children to store their belongings by the main entrance. There were plenty of age-appropriate toys, books, learning material, art and craft material, and children's furniture available for the children. There was a fully charged 2A10BC fire extinguisher and first aid supplies available in the daycare. LPA did not test the smoke and carbon monoxide detector because the children were napping during the inspection. There were no guns, no weapons, and no pets at home. The facility has provided breakfast, AM/PM snacks, & lunch to the children. Cots and cribs were available for napping. All electrical outlets were covered. The licensee installed the carpets on the daycare floor to prevent injury. The children's bathroom was clean. The lower bathroom sink cabinet was locked, and toxins and harmful objects were made inaccessible to the children. The outdoor play yard was completely fenced. There were some outdoor toys, a playhouse, a slide structure, sandboxes, see-saw and ride-on toys available for the children. The licensees installed the fake grass as the soft cushioning to the outdoor ground. The licensees and a helper had current CPR/First Aid Training, they will expire in 9/2024 and 11/2025. All staff had current Child Abuse Mandated Reporter Training. There were no children on special medication. The facility had all required postings. LPA reviewed the staff and children's files during the inspection. The facility has conducted the fire drill at least 2 times a year and logged. continues in LIC 809C.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024

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: FRIEDMAN, SHIFRA V. & PIL, MENACHEM M.	FACILITY NUMBER: 384004033
	VISIT DATE: 04/02/2024

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 [or facility representative] 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 [or facility representative] 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: 04/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024

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: FRIEDMAN, SHIFRA V. & PIL, MENACHEM M.	FACILITY NUMBER: 384004033
	VISIT DATE: 04/02/2024

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, Mendel Pil 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, Mendel Pil.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Mok	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/02/2024

LIC809 (FAS) - (06/04)

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