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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410503311
Report Date: 12/02/2022
Date Signed: 12/02/2022 04:15:16 PM


Document Has Been Signed on 12/02/2022 04:15 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:MILLBRAE NURSERY SCHOOL, INCFACILITY NUMBER:
410503311
ADMINISTRATOR:BOGNI-RODRIGUEZ, BRIGIDANFACILITY TYPE:
850
ADDRESS:86 CENTER ST.TELEPHONE:
(650) 589-3028
CITY:MILLBRAESTATE: CAZIP CODE:
94030
CAPACITY:44CENSUS: 2DATE:
12/02/2022
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:28 PM
MET WITH:Brigidan Bogni-RodriguezTIME COMPLETED:
04:30 PM
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On December 2, 2022 at approximately 03:00 pm, Licensing Program Analysts (LPAs) Nathan Garcia and Maria Olguin-Leon conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. LPA met with the Site Director, Brigidan Bogni-Rodriguez. The purpose of the inspection was explained.

Present in facility are 2 children, present with 5 staff members during closing time.

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 8/10/2022. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and putting signs indicating that the water fountain/kitchen fixture is not for drinking and or currently out of order. Per director, there are no intentions of using the faucets affected with high level of lead for water ingestion or food preparation. The faucet located in the cleaning closet will not be in use, and always been used to wash their art, vacuums and other cleaning supplies. Per director, the children never had access to the area where the affected fixture is located. The fixture will only be used for washing supplies and director reassured LPAs of this statement. Per director and LPAs observations, the facility provided the staff members a sign notifying them to not use for ingestion from the particular faucet. According to the director, the facility has another fixture where they source their water for children and staff. Per director, she still plans to fix the fixture.

LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), in an email to the LPA.

A copy of this report, and the “Notice of Site Visit,” were given to the director.

A “Notice of Site Visit” must remain posted for 30 days.

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 Director, Brigidan Bogni-Rodriguez.
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan GarciaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 12/02/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/02/2022
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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