410503906-9-19-2023-05-CC-MTSO-CVU6UJ-20230919210709

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410503906
Report Date: 09/19/2023
Date Signed: 09/19/2023 09:09:02 PM

Document Has Been Signed on 09/19/2023 09:09 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CHILDRENS PLACE, THE		FACILITY NUMBER:	410503906
ADMINISTRATOR:	BAKSA, KATALIN		FACILITY TYPE:	850
ADDRESS:	1336 ARROYO AVENUE		TELEPHONE:	(650) 595-1910
CITY:	SAN CARLOS	STATE: CA	ZIP CODE:	94070
CAPACITY:	36	CENSUS: 27	DATE:	09/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Katalin Baksa		TIME COMPLETED:	06:05 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	During an unannounced annual inspection on September 19, 2023, Licensing Program Analyst (LPA) Tso and LPA Olguin-Leon met with Director Katalin Baksa to ensure compliance with regulations. The Director granted entry to the preschool program, and it was observed that there were five staff members present and 27 preschool children under their supervision. The facility complied with staff-children’s ratios, and all staff members had criminal record clearances on file. The facility operates Monday - Friday from 7:15 a.m. to 5:45 p.m. The Director and LPAs conducted a thorough inspection of the physical plant to identify potential health and safety hazards. The facility has both an electronic system and manual sign-in/out records. LPAs observed that there is no signature on the manual sign in/out record. LPAs reminded licensee to add the column for parents’ signature on the manual log. The facility is in good condition and maintains proper temperature and ventilation levels. Age-appropriate toys and educational materials are available in each classroom, and the furniture is sturdy and well-maintained. Moreover, the facility is equipped with multiple combinations of carbon monoxide and smoke detectors, fully charged fire extinguishers, and functioning telephones. The Director tested combinations of carbon monoxide and smoke detectors and proved that they are functionable. LPA noticed that each child has cubbies, and emergency supplies are securely stored. First aid supplies are fully stocked and readily accessible to children. However, one of the child's medications was expired. LPAa reminded the licensee to return to the child's parents and replace the valid one. All hazardous materials, including cleaning solutions and poisons, are stored out of reach of children. Sleeping cots are appropriately stored, and medications are securely kept in high cabinets inaccessible to children. The toilets and handwashing sinks are in good working condition and regularly sanitized. Lastly, LPA confirmed that no bodies of water are on the premises. Continued on page 2...

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHILDRENS PLACE, THE	FACILITY NUMBER: 410503906
	VISIT DATE: 09/19/2023

NARRATIVE

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The outdoor play area is maintained clean and clutter-free. It is also securely fenced and well-maintained to ensure the safety of all children. Play structures are checked regularly for damage and loose parts, with soft cushioning placed beneath them to prevent injuries from accidental falls. LPAs observed that there is a fallen dried up tree branch on outdoors area. Licensee stated that it is for teaching purpose. LPAs reminded the Director to use it under close supervision of the teachers. LPAs observed a broken toy car and reminded the licensee to move immediately.
LPA reminded the Director to check and clear any debris or harmful material from the playground before use in accordance with regulations.

During the inspection, LPA reviewed records pertaining to children and personnel. Children’s records revealed that the facility has complete records of each child, including their names, addresses, and authorized representative telephone numbers. Additionally, each child's file contains information about their immunization record, medical assessment, and admission agreement. Staff members' records showed that all individuals requiring caregiver background checks had undergone criminal records and child abuse index clearances or exemptions. Furthermore, several staff members possess valid CPR certificates, and all staff maintain up-to-date immunization records. LPAs examined the educational qualifications of the staff and confirmed that everyone had completed the required ECE units. The Center's Director informed us that they conduct fire and earthquake drills monthly, with the most recent drill occurring on September 5, 2023.

The facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). However, the phone number of the local health department of the Child Passenger Restraint System Poster (PUB 269) filled in 211 only. LPAs reminded the Director to write down the number of local health department. Per the Director, the Center provides two snacks (AM & PM) to children. Children bring their own labeled bottle of water and refill at the Center via the water filter. All storage containers for solid waste within the Center have a proper tight-fitting cover.
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SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHILDRENS PLACE, THE	FACILITY NUMBER: 410503906
	VISIT DATE: 09/19/2023

NARRATIVE

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The 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 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.

This facility provides Incidental Medical Services – IMS. LPAs reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514- 0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/
The Director was informed about Mandated Reporter training. In addition to AB1207 training required to be completed every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.
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SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CHILDRENS PLACE, THE	FACILITY NUMBER: 410503906
	VISIT DATE: 09/19/2023

NARRATIVE

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For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1- CCP).

The Center completed testing and is in the process of remediating LEAD exceedances and discussed with a LPA. LPA Olguin-Leon would further clarify with the LPA the progress. LPA Olguin-Leon would revisit the Center by early next week to have a decision on the potential deficiency.

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

An exit interview was conducted, and the report was reviewed with the Director, Katalin Baksa. Today's report and site visit notice were provided to the Director. LPAs informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Man Tso	TELEPHONE: (650) 379-9021
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2023

LIC809 (FAS) - (06/04)

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