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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004173
Report Date: 10/18/2022
Date Signed: 10/18/2022 12:21:49 PM

Document Has Been Signed on 10/18/2022 12:21 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:SHINING STAR BILINGUAL MONTESSORIFACILITY NUMBER:
384004173
ADMINISTRATOR:WANG, FEIFEIFACILITY TYPE:
850
ADDRESS:610 20TH STREETTELEPHONE:
(415) 881-1883
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94107
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 4DATE:
10/18/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:Qun LuoTIME COMPLETED:
12:36 PM
NARRATIVE
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On 10/18/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Shining Star Bilingual Montessori facility. The LPA was granted entry by the Teacher, Qun Luo. The LPA explained the purpose of the visit to the teacher. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The LPA observed one teacher supervising four preschool children. Children's capacity and ratio requirements were observed to be in compliance,

LPA and the teacher both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA saw that the playground equipment and outdoor furnishings are in very good shape. The outdoor play structures are surrounded by rubberized cushions, which can cushion any falls that may occur. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order. The teacher has stated that the facility does not house any firearms or other types of weapons.



The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

The LPA reviewed the records of four children. All required forms were in the children’s’ file. The program uses a sign in / out sheet for authorized individuals to sign their children in and out.
***See Page 2 for continuation***
Daniel J Oquendo
Hanson Leong
DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 10/18/2022 12:21 PM - It Cannot Be Edited


Created By: Hanson Leong On 10/18/2022 at 11:10 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SHINING STAR BILINGUAL MONTESSORI
FACILITY NUMBER: 384004173

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022

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, one of the staff members did not complete their Mandated Reporter Training, which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/18/2022
Plan of Correction
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Licensee will submit the departments director package to the LPA which includes the Mandated Reporter Training by POC date.
Type B
Section Cited
CCR
101216(f)
Personnel Requirements
(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, one of the staff members did not complete their CPR/First Aid Training from an approved EMSA vendor, which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/18/2022
Plan of Correction
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Licensee will submit the departments director package to the LPA which includes the CPR/First AId Training by POC date.
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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2022


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Document Has Been Signed on 10/18/2022 12:21 PM - It Cannot Be Edited


Created By: Hanson Leong On 10/18/2022 at 11:10 AM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SHINING STAR BILINGUAL MONTESSORI
FACILITY NUMBER: 384004173

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101212(b)
Reporting Requirements
(b) The name of the child care center director, and any fully qualified teacher(s) designated to act in the child care center director's absence, shall be reported to the Department within 10 days of a change of child care center director or designee(s).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review and interview, the licensee failed to inform the department of a director change within ten days, which poses a potential health, safety or personal rights risk to children in care.
POC Due Date: 11/18/2022
Plan of Correction
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Licensee will submit the departments director package to the LPA by POC 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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 10/18/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2022


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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: SHINING STAR BILINGUAL MONTESSORI
FACILITY NUMBER: 384004173
VISIT DATE: 10/18/2022
NARRATIVE
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Continued, Page 2
The LPA reviewed the records of one staff member. All required forms were in the staff files. A review of staff files revealed that one staff member is not currently certified in CPR and First Aid and has an expired Mandated Reporter Training certificate. Neither the licensee nor a director were present during the visit. The LPA contacted the licensee, who informed the LPA that the previous director had resigned in August 2022. The LPA informed the teacher that the facility would receive three Type B violations for failing to have a current CPR/First Aid certificate for at lease one staff member. Mandated Reporter Training certificate, as well as failing to notify the department of a director change within ten days.

The LPA has informed the teacher that a Plan of Correction would be provided for all Type B violations. This Plan of Correction will enable the licensee to correct the violations. 

According to the teacher, the facility simulates and documents fire and earthquake drills twice a year.

The teacher 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.



Incidental Medical Services (IMS) policy was discussed with the teacher. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The LPA encouraged the teacher to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The teacher can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

A copy of this report, the “Notice of Site Visit,” and their appeal rights were given to the teacher. A Notice of Site Visit must remain posted for 30 days. ***See Page 3 for continuation***
SUPERVISOR'S NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022
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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: SHINING STAR BILINGUAL MONTESSORI
FACILITY NUMBER: 384004173
VISIT DATE: 10/18/2022
NARRATIVE
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Continued, Page 3
Failure to comply with posting requirements shall result in an immediate civil penalty of $100

.An exit interview was conducted, and the report was reviewed with the teacher, Qun Luo

SUPERVISOR'S NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2022
LIC809 (FAS) - (06/04)
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