414001067-5-2-2024-05-CC-WLYY-D4VV2Z-20240502160356

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001067
Report Date: 05/02/2024
Date Signed: 05/02/2024 04:04:02 PM

Document Has Been Signed on 05/02/2024 04:04 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CITY OF PACIFICA VALLEMAR CHILDREN'S CENTER		FACILITY NUMBER:	414001067
ADMINISTRATOR:	GRETCHEN HAYES		FACILITY TYPE:	840
ADDRESS:	377 REINA DEL MAR		TELEPHONE:	(650) 738-7466
CITY:	PACIFICA	STATE: CA	ZIP CODE:	94044
CAPACITY:	150	CENSUS: 115	DATE:	05/02/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Majadallen Musieh		TIME COMPLETED:	04:15 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 May 02, 2024, at approximately 2:00pm, Licensing Program Analysts (LPAs) Ly and Gil conducted an Unannounced Annual Inspection and met with Site Director, Majadallen Musieh. Purpose of the visit was explained. Program operates Monday-Friday before-school, 7:00am-8:20am and after-school, 1:30pm-6:00pm during the school year. Present during the visit were Site Director and 12 staff caring for 115 School Age children. School age classrooms are in 5 portables. All portables observed to be clean and orderly. There were no bodies of water present at the center. Per Site Director, there are no firearms or weapons. Disinfectants, cleaning solutions and other potentially harmful items were inaccessible to the children. Medications are stored in children's individual backpack. The furniture and equipment are in good condition, free of sharp, loose or pointed parts. All solid waste storage containers have secure, tight fitting lids. Afternoon snack is provided by the center. Drinking water is available by children's individual bottles. Each classroom is equipped with a fully charge fire extinguisher, smoke detectors and carbon monoxide detectors. Females restrooms and males’ restrooms are separated from each other. LPA observed outdoor equipment is in good condition. Program is using a binder for staff or parents to sign children in and out of the program. Last Emergency Drill was conducted on 03/20/2024 and is properly logged. First Aid Kit and Emergency supplies are properly maintained and kept inaccessible to children. Cleaning products and Toxins are maintained inaccessible to children. CONTINUED>>>...PAGE 2...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie Ly	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

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 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: CITY OF PACIFICA VALLEMAR CHILDREN'S CENTER	FACILITY NUMBER: 414001067
	VISIT DATE: 05/02/2024

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

Page 2...

During today's visit, a random sample of children's files were reviewed and found to be complete. In the staff files reviewed, all have the verification of meeting the educational requirements; verification of the required staff immunization, or proof of immunity. At least one staff have current Pediatric First Aid and CPR. Facility has posted all the required licensing forms in a prominent accessible location.

Facility provides Incidental Medical Services (IMS) to the children. Per Director, children carry their own medication in the backpack from their day school to the afterschool program.

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.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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.

CONTINUED>>>...PAGE 3...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie Ly	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: CITY OF PACIFICA VALLEMAR CHILDREN'S CENTER	FACILITY NUMBER: 414001067
	VISIT DATE: 05/02/2024

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

Page 3....

Facility Representative 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.

Facility Representative 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.

Facility was also informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Director. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one hour online course is available on the Department of Pesticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

An Exit Interview was conducted with Director. No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report and appeal rights were discussed and left with Director whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Winnie Ly	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/02/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/02/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3