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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410500593
Report Date: 02/26/2020
Date Signed: 02/26/2020 11:59:23 AM

COMPREHENSIVE INSPECTION
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:ST. ANDREW'S PRESCHOOLFACILITY NUMBER:
410500593
ADMINISTRATOR:MCLAUGHLIN, JEANNEFACILITY TYPE:
850
ADDRESS:1600 SANTA LUCIA AVETELEPHONE:
(650) 273-4415
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY:52CENSUS: 53DATE:
02/26/2020
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Teacher Katherine Vo and Director Jeanne MclaughlinTIME COMPLETED:
12:00 PM
NARRATIVE
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Licensing Program Analyst Jyoti Saini met with Teacher Katherine Vo for an annual random inspection today. Purpose of the inspection was explained to her was for required 1 year inspection. Program Director Jeanne Mclaughlin arrived later during the inspection. The Preschool program operates at St. Andrew’s Episcopal Church from Monday to Friday 7:30am- 6:00pm. Facility operates in 2 large classrooms, which are divided among different age groups as Rainbow classroom, Parrot classroom, sunshine classroom, art classroom and science classroom. At 10:14am, LPA observed that Director and 8 Staff supervising 53 PreK children however facility is licensed to take care of 52 children only. LPA and Teacher Kaitherine inspected the facility for health and safety hazards. No apparent hazards were observed. There are total of 4 toilets and 2 sinks available for children's use. All toilets and sinks are in safe and sanitary operating conditions. Center is adequately furnished with age appropriate toys, furniture, and equipment. Cubbies are available for children in the facility. There are Separate staff bathroom available for staff on site. Isolation area for ill child is office. The outdoor area has play structures, the structures were observed to be in good condition Facility is clean and orderly today. Napping equipment is available for children. Per director, parents take blankets home to wash every Friday. Drinking water is readily available for children indoor and outdoor. Facility has posted the required forms (ie License, menus, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Last Emergency Disaster drill was conducted on 10/22/19 and is properly logged. Cleaning supplies and toxins are maintained off limits to children. Discipline policy is mainly redirection. Program provides snacks and children bring their own meals. Program has electronic sign in/ sign out system.
LPA reviewed staff files, all have the verification of meeting the educational requirements. Staff have verification of the required immunization's and verification of the required mandated child abuse reporting training on file.
LPA reviewed randomly 8 children's files. All files are complete and up to the date.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
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 3
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: ST. ANDREW'S PRESCHOOL
FACILITY NUMBER: 410500593
VISIT DATE: 02/26/2020
NARRATIVE
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Also during inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Facility was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare.
*Director was reminded about the Provider Information Notices (PINs) on CCLD website.

> Deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations: See LIC 809D.
An exit interview was conducted and plans of corrections were reviewed and developed with Director. Reports citing Type A violations are to be provided to parents/guardians of children currently in enrolled and to parents/guardians of children newly enrolled at the facility during the next 12 months. Parents/guardians must sign Form LIC9224 to be kept in each child's file. LPA provided a copy of Form LIC 9224 to Director.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/26/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3
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: ST. ANDREW'S PRESCHOOL
FACILITY NUMBER: 410500593
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/26/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
02/27/2020
Section Cited

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101161(a) Limitations on Capacity and Ambulatory Status. A licensee shall not operate a childcare center beyond the conditions and limitations specified on the license, including the capacity limitation.
This requirement is not met as evidenced by:
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Based on records review,and observation, At 10:15am, 53 children are electronically signed into the programe.Facility is over the licensed capacity by 1 children.
This poses an immediate health and safety risk to children in care.
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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: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti SainiTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/26/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/26/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3