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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002750
Report Date: 02/16/2023
Date Signed: 02/16/2023 01:34:35 PM


Document Has Been Signed on 02/16/2023 01:34 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:BUILDING KIDZ OF SSF, INC. (INFANT)FACILITY NUMBER:
414002750
ADMINISTRATOR:JAQUELINE GALDAMEZFACILITY TYPE:
830
ADDRESS:600 GRAND AVENUETELEPHONE:
(650) 837-9348
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY:25CENSUS: 15DATE:
02/16/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:45 AM
MET WITH:Jackie Galdamez, Ana GaldamezTIME COMPLETED:
01:45 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with facility representative for this required annual licensing visit. Purpose of visit explained. Days and hours of operation: Monday-Friday 7:00AM-6:00PM. Physical plant toured to inspect for health and safety hazards. There are 15 infants present during the visit. Facility meets teacher/infant ratio today. There are fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and carbon monoxide detectors (CO) in the facility. Facility is licensed as a combination center which includes: infant and preschool programs. Facility is adequately furnished with age appropriate toys, furniture, cribs, changing tables, and equipment. Separate staff bathrooms are available. Parent's provide diapers and formula. Sinks are present in the classrooms and located near the changing tables. No pools, spas, hot tubs, fish ponds or similar bodies of water are present. Disinfectants, cleaning solutions, poisons, and toxics are inaccessible to children. Per director, there are no firearms or weapons on site. Classrooms are set up for infants and furniture and equipment for is present. Adequate first aid supplies are available. Facility has posted all the required licensing forms in a prominent accessible location. LPA reviewed staff and infant files. In the files that were reviewed, all infants have complete files including an infant feeding plan, infant needs and services plan, and individual infant sleeping plan. In the staff files, all have complete files including the required staff immunizations; verification of the appropriate educational requirements; verification of the mandated child abuse reporting training as compliant with AB1207. All staff have current Pediatric First Aid and CPR certification.

(Continued on next page 809-C)
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/16/2023
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BUILDING KIDZ OF SSF, INC. (INFANT)
FACILITY NUMBER: 414002750
VISIT DATE: 02/16/2023
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Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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: http://www.ada.gov/childqanda.htm. Facility informed that effective 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

This report is reviewed with facility representative and a copy of this report must be made available for public review upon request.

Notice of Site Visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/16/2023
LIC809 (FAS) - (06/04)
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