414002928-5-3-2023-05-CC-CQUO-CRGSC2-20230503134448

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002928
Report Date: 05/03/2023
Date Signed: 05/03/2023 01:44:54 PM

Document Has Been Signed on 05/03/2023 01:44 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:	MILESTONE ACADEMY PRESCHOOL		FACILITY NUMBER:	414002928
ADMINISTRATOR:	LIM, THEINGI		FACILITY TYPE:	850
ADDRESS:	444 E. MARKET ST., RMS 3,4 & 5		TELEPHONE:	(650) 755-2348
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94014
CAPACITY:	63	CENSUS: 28	DATE:	05/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Theingi Lim		TIME COMPLETED:	02:00 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 3, 2023 at approximately 11:10am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with licensee/director, Theingi Lim, and explained the purpose of the inspection. Preschool program operates on Colma Elementary School Site in classrooms #3-5 only. Present during LPA's visit included director, 3 teaching staff and 28 preschool children. Facility is operating within capacity limits and ratio during LPA's visit. Program operates Monday through Friday 7:30am to 5:30pm. LPA inspected the preschool classrooms and outdoor areas currently in use, for health and safety hazards. During LPA's visit, only classrooms #4 and #5 were in operation. Half of the licensed playground was also currently in use. During LPA's visit, toys, materials and furniture were being cleaned. Per director, toys, materials and furniture out are cleaned, moved and changed throughout the year. LPA did not observe poisons, chemicals or hazardous materials to be accessible during classroom clean up. LPA observed both classrooms to have a fire alarm system, working smoke/ carbon monoxide detectors and fire extinguishers. Electrical outlets are made inaccessible by furniture. LPA observed cleaning solutions, poisons and other chemicals to be stored inaccessible to children in facility's high cabinets. Classrooms have age appropriate furniture and materials that were in good working condition. Storage for children's belongings are located inside the classroom, labeled with children's names. Program has sufficient amount of sleeping cots for napping children that were appropriately stored. Children's sheets are stored inside their individual cubbies and are sent home weekly. Children's bathroom is located inside classroom #5. LPA observed bathroom to be in proper working condition with appropriate toileting equipment. Garbage bins located in classroom and bathroom were observed to have tight fitting lids. There is a changing table that is within arm's reach to an adult sink. Sinks children have access to do not provide water that is warmer than 120 degrees Fahrenheit. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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: MILESTONE ACADEMY PRESCHOOL	FACILITY NUMBER: 414002928
	VISIT DATE: 05/03/2023

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...)
Program provides a food service that is prepared in kitchen area in classroom #5. LPA observed kitchen prep area to be free of any chemicals to avoid contamination. Menu for food service is properly posted and available for review. Per director, children's families have option to provide their own meals as well. LPA observed children's food brought from home to be labeled with each child's individual names.

Outdoor area is fully fenced and enclosed with an at least 4 ft. high fence. Outdoor area was observed to have age appropriate toys and materials that were in good working condition. Entire outdoor flooring is cushioned with appropriate padding. Water is made available to children indoors and outdoors with children's individual water bottles that are refilled through accessible water fountains in classrooms. Per director, cups are provided to children if needed.

Program uses a paper sign in/out system. At time of inspection, all children were properly signed in to program with children's authorized representatives' signatures. LPA observed classroom has license and required licensing documents to be posted and visible for review. Last emergency disaster drill was conducted 01/04/2023. Emergency drills are conducted and documented at least once every six months.

LPA reviewed seven random children's files. Children's files were complete with a record of emergency identification information on file. Multiple staff members on site have a current CPR/First Aid certification. Director's CPR/First Aid will expire 01/2024. All staff on site have a current Mandated Reporter certification and required immunizations that were made available for review.

Director was reminded 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.

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.
(Continue Report on Page 3..)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

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: MILESTONE ACADEMY PRESCHOOL	FACILITY NUMBER: 414002928
	VISIT DATE: 05/03/2023

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...)
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/inspection-process.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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: http://www.ada.gov/childqanda.htm

No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. Failure to maintain posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director/licensee, Theingi Lim.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2023

LIC809 (FAS) - (06/04)

Page: 3 of 3