414001700-1-22-2025-05-CC-KKRN-DD725W-20250122160613

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001700
Report Date: 01/22/2025
Date Signed: 01/22/2025 04:06:27 PM

Document Has Been Signed on 01/22/2025 04:06 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:	KHO, MERIAM TUAZON		FACILITY NUMBER:	414001700
ADMINISTRATOR/ DIRECTOR:	KHO, MERIAM T.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 226-3900
CITY:	BELMONT	STATE: CA	ZIP CODE:	94002
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 12	CENSUS: 11	DATE:	01/22/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:30 PM
MET WITH:	Meriam Kho		TIME VISIT/ INSPECTION COMPLETED:	04:20 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 January 22, 2025 at approximately 1:30pm, Licensing Program Analysts (LPAs) Katie Krenn and Jonathan Tse conducted an unannounced, annual inspection. LPAs met with licensee, Meriam Kho, and explained the purpose of the visit. Present during LPA's visit included licensee, teacher assistant (TA), and 11 preschool children. Facility is operating within capacity limits and ratio during LPA's visit. All adults living and/or working in the home have fingerprint clearance on file. Hours of operation are Monday to Friday 9:00am to 5:00pm. Licensee operates with children ages 2.5 years to 5 years old. LPAs conducted a health and safety inspection inside and outside the home. The home is a single family home. Entrance to facility is through side gate. DAY CARE AREAS are the living room (main classroom), bedroom #1 (next to living room), bedroom #3 (isolation room), kitchen, bathroom #2 (hallway bathroom), garage converted into a second classroom with bathroom #1, computer/activity room (next to laundry room), backyard and front yard. OFF LIMIT AREAS are bedroom #2 and laundry room (located in computer/activity room). Off limit areas are made inaccessible with child safety door handles. Licensee operates home as a Montessori program. LPAs observed home to be clean and well ventilated. There were a variety of Montessori materials that were in good working condition. Home is equipped with furniture, toys and equipment that were observed to be age appropriate. Main classroom includes a fireplace that was made inaccessible to children and appropriately barricaded. Edges on fireplace and sharp edges in home were properly padded for additional safety. LPA observed cleaning supplies, poisons and other chemicals to be inaccessible behind child safety locked cabinets, closets, or located in an off-limits areas. (Continue on Page 2...)

Daniel J Oquendo	TELEPHONE: (650) 266-8800
Katie Krenn	TELEPHONE: 650-266-8800
	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

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

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: KHO, MERIAM TUAZON	FACILITY NUMBER: 414001700
	VISIT DATE: 01/22/2025

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...)
LPAs observed bathrooms to be in proper working condition, with appropriate sanitation products. Cabinets and drawers are made inaccessible to children with multiple child safety locks. Home is equipped with multiple emergency backpacks, first aid supplies, fire extinguisher 2A10BC, and a working smoke/carbon monoxide detector, which LPAs tested.

LPAs observed both front yard and backyard to be entirely fenced and enclosed. Backyard is equipped with appropriate outdoor materials that were observed to be in good, working condition. Outdoor area includes age appropriate play structures that were observed to have artificial grass resilient padding underneath. LPAs did not observe any pools, spas or bodies of water on site. Water is made available to children indoors and outdoors with children's individual water bottles.

LPAs observed that each child has their own mat and bedding, which is send home on Fridays to be laundered.

Home is equipped with a working phone on site. Phone number listed for licensee is current. Per licensee, there are no weapons or firearms in the home. Emergency drills are conducted regularly and are properly logged. Last emergency disaster drill was conducted 12/16/2024. Per the licensee earthquake drills and fire drills are done every 3 months. LPAs observed licensing documentation to be properly posted and made available for review.

LPA reviewed facility records that included 11 children files, licensee's and TA's files. All files were observed to be complete. Children's files have a record of emergency identification information as well as required immunizations. Both licensee and TA have a current CPR certification that will expire 08/2025. Both licensee and TA have Mandated Reporter certification that expired 03/2024. Both licensee and TA have required immunizations that were made available for review.

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: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Katie Krenn	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

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: KHO, MERIAM TUAZON	FACILITY NUMBER: 414001700
	VISIT DATE: 01/22/2025

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

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

LPA discussed the safe sleep regulations with Licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Licensee 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.

During the exit interview, Licensee, confirmed that there are no Registered Sex Offenders living in the facility and LPAs completed the RSO profile in FAS.

One deficiency was issued today for expired Mandated Reporter Training. Appeal rights were explained and provided to the licensee.

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

Exit interview conducted and report was reviewed with the licensee, Meriam Kho.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Katie Krenn	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 01/22/2025 04:06 PM - It Cannot Be Edited

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: KHO, MERIAM TUAZON	FACILITY NUMBER: 414001700
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/22/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in two out of two staff files which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 02/11/2025
	Plan of Correction
1 2 3 4	Licensee and staff will complete the Mandated Reporter Training and send the certificates by February 11th, 2025 via email to the LPA.

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.

Daniel J Oquendo	TELEPHONE: (650) 266-8800
Katie Krenn	TELEPHONE: 650-266-8800
	DATE: 01/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/22/2025

LIC809 (FAS) - (06/04)

Page: 4 of 4