410509659-12-3-2024-05-CC-MZAA-DBLRTS-20241203121849

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410509659
Report Date: 12/03/2024
Date Signed: 12/03/2024 12:18:57 PM

Document Has Been Signed on 12/03/2024 12:18 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:	NORTH HILLSBOROUGH PRESCHOOL		FACILITY NUMBER:	410509659
ADMINISTRATOR/ DIRECTOR:	TRUE, MARCIA		FACILITY TYPE:	850
ADDRESS:	545 EUCALYPTUS AVENUE		TELEPHONE:	(650) 342-1478
CITY:	HILLSBOROUGH	STATE: CA	ZIP CODE:	94010
CAPACITY: 25	TOTAL ENROLLED CHILDREN: 25	CENSUS: 14	DATE:	12/03/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Director of recreation, Tony Giacomazzi		TIME VISIT/ INSPECTION COMPLETED:	12:30 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	On December 3, 2024, at approximately 9:00 AM, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA met with Director of Recreation, Tony Giacomazzi, and explained the purpose of the visit. North Hillsborough Preschool is a preschool age program. Preschool program operates one classroom, room 16. Hours of operation are Monday through Friday 8:30am to 11:30am and 12:30pm-3:30pm. Present during LPA's visit was the director of recreation, 14 preschool age children and 3 teachers. Program is operating within capacity limits and ratio during LPA's visit. Background fingerprints for all adults present are done through the Hillsborough City School District. LPA inspected facility, indoors and outdoors, for health and safety hazards. Classroom includes a variety of toys and materials that were in good condition. LPA observed classroom to have age-appropriate furniture, equipment, and materials. LPA observed cleaning materials to be stored in high shelves, inaccessible to children in care. Per director, children do not sleep while they are in preschool, but they are welcome to take a break if they are feeling tired in bean bags. Per director, they have a short schedule, when children arrive, they are in the class learning and working, and get a snack. After, children get ready for pick up, and parents pick up children at 11:30am. The classroom is equipped with a fully charged fire extinguisher and first aid kit. LPA observed Carbon monoxide detector and smoke detector in the classroom. Carbon monoxide detector was tested during visit and was observed to be working. LPA was unable to test smoke alarm. Per director, smoke alarm is wired with the school. Storage for children's belongings is outside the classroom. Children's cubbies are labeled with children's individual names and pictures. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024

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 4

Document Has Been Signed on 12/03/2024 12:18 PM - It Cannot Be Edited

Created By: Melissa Zaragoza On 12/03/2024 at 11:34 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: NORTH HILLSBOROUGH PRESCHOOL	FACILITY NUMBER: 410509659
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/03/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

101700(b)

Written Directives for Lead Testing

(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above by not having lead water results posted on the Waterboard website, which poses a potential health, safety or personal rights risk to persons in care. Per director, they test for lead water yearly with in the school district.
	POC Due Date: 01/03/2025
	Plan of Correction
1 2 3 4	Per director, they plan to contact lead water examiners, and have results posted.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Melissa Zaragoza

LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024

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: NORTH HILLSBOROUGH PRESCHOOL	FACILITY NUMBER: 410509659
	VISIT DATE: 12/03/2024

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
26
27
28
29
30
31
32

(Continued, Page 2...)
There is one bathroom in the classroom for the children. Bathroom for children was observed to be clean. Bathroom has 2 toilet stalls and 2 sinks. The sinks and toilet were in working condition. Bathroom was equipped with appropriate sanitation products. LPA observed no cleaning solutions, poisons, and other hazardous materials for to be stored in bathroom. LPA did not observe any accessible poisons or chemicals in classroom.

Program provides snacks only. Per director, children are welcome to bring snack from home. Per director, children store their lunch bags and water bottles in their individual cubbies. Per director, preschool program is a nut free program, and there are currently no children with allergies or food restrictions enrolled.

Outdoor area is entirely enclosed and fenced. LPA observed outdoor play area to have natural shade. LPA observed play structure to have sand flooring. Outdoor materials are stored outside in cubbies. Per director, there is a person assigned to sweep the sandbox before children arrive. LPA observed toys and material to be in good conditions. Per director, children can take their personal water bottles outside, and refill them in the classroom.

Program uses a form for parents to sign in and out for their sign in/sign out system. Children were properly signed in during LPAs’ visit. LPA observed licensing posters and required documents to be properly posted inside the classroom. Program’s last disaster drills was conducted on May 1, 2024.

LPA reviewed 3 facility staff records which were complete. LPA reviewed 6 random children facility records which were complete and had all required documents. Children's records have emergency information on file. All staff on site have a current CPR/First Aid certification and Mandated Reporter certificates. Certificates are renewed yearly through the school district.Staff records also include required immunization's that were made available for review.

Director was reminded all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024

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: NORTH HILLSBOROUGH PRESCHOOL	FACILITY NUMBER: 410509659
	VISIT DATE: 12/03/2024

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
26
27
28
29
30
31
32

(Continued, Page 3...)
Director was reminded that all adults 18 and over, 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 Child Care Center. 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.

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.

Water quality was tested through the school district and results have not been posted to the Waterboard website. Per director, the school districts test their water yearly.

LPA's discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed director 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 22-02-CCP. 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) 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-care-centers/.

Director 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.

Program was cited a Type B citation for not completing lead water testing requirement by not posting their lead water results to the Water Board Website. Appeal Rights were provided.

Please see LIC 809-D for deficiencies cited today.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the director, Tony Giacomazzi.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 12/03/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4