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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414003012
Report Date: 05/03/2024
Date Signed: 05/03/2024 02:05:37 PM


Document Has Been Signed on 05/03/2024 02:05 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:EPISCOPAL DAY SCHOOL OF ST. MATTHEWFACILITY NUMBER:
414003012
ADMINISTRATOR:HUDEC, ERINFACILITY TYPE:
850
ADDRESS:15 2ND AVENUETELEPHONE:
(650) 342-5436
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY:34CENSUS: 18DATE:
05/03/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:06 PM
MET WITH:Katherine Semien and Erin HudecTIME COMPLETED:
02:15 PM
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On 5/3/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced case management visit to the child care center listed above. The purpose of the visit was to determine whether the lead water testing had been completed. LPA met with the Pre-K teacher. Katherine Semien, and explained the purpose of the visit. At 1:40 pm, the Director, Erin Hudec, arrived at the CCC. Eighteen preschool-aged children and four staff members were present in the CCC. The four staff members present at the CCC, received criminal record clearance from the department. The CCC operates within its capacity and in accordance with the required ratio of staff to children.

The department reviewed the supporting documents from the CCC regarding the lead water testing and found that the lead water sample was analyzed on 3/25/2020. However, the lead water testing vendor did not submit the lead results to the California Waterboards website.

The department will request the director to contact the lead water testing vendor and have them upload the results to the California Waterboards website. The department will also request the director to keep the department updated regarding the lead results being uploaded to the California Waterboards website.

LPA reminded the director that lead water testing must be completed every five years after the initial test per Health & Safety Code 1597. 16(a)(1).

No deficiencies were issued today during LPA's visit.

A copy of todays report was given to the director.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Erin Hudec.

SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson LeongTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/03/2024
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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