414003012-4-18-2024-05-CC-HLEG-D4G293-20240418171115

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414003012
Report Date: 04/18/2024
Date Signed: 04/18/2024 05:11:25 PM

Document Has Been Signed on 04/18/2024 05:11 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. MATTHEW		FACILITY NUMBER:	414003012
ADMINISTRATOR:	HUDEC, ERIN		FACILITY TYPE:	850
ADDRESS:	15 2ND AVENUE		TELEPHONE:	(650) 342-5436
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94401
CAPACITY:	34	CENSUS: 11	DATE:	04/18/2024
TYPE OF VISIT:	Annual/Required	UNANNOUNCED	TIME BEGAN:	02:24 PM
MET WITH:	Erin Hudec		TIME COMPLETED:	05:25 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 4/18/2024, Licensing Program Analysts (LPAs) Leong and Maiwandi conducted an unannounced annual visit to the Child Care Center (CCC) listed above. LPAs met with the Director, Erin Hudec, and explained the purpose of the visit. Eleven preschool aged children and four staff members were present during the visit. The four staff members present at the CCC have all received criminal record clearance from the department. The CCC operates within its capacity and in accordance with the required ratio of staff to children. LPAs observed that all required documents, such as the facility license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities, were displayed in the CCC. LPAs observed that the last emergency disaster drill was conducted on 3/19/2024 and properly recorded. According to the director, the children are responsible for bringing their own lunch to the CCC, as the CCC only provides snacks. LPAs observed that snacks were available at the CCC, and the children brought their own lunch boxes and water bottles. LPAs and the Director conducted an inspection to identify potential health and safety hazards. LPAs observed that the inside of the CCC was clean, safe, sanitary, and in good repair. The CCC is equipped with a fully stocked first aid kit, functioning smoke and carbon monoxide detectors, and a fully charged fire extinguisher. LPAs observed that the classrooms were equipped with age-appropriate toys, furniture, and educational materials. LPAs observed that each child has an individual permanent or portable storage space for his/her clothing and personal belongings at the CCC. See Page 2

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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 4

Document Has Been Signed on 04/18/2024 05:11 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: EPISCOPAL DAY SCHOOL OF ST. MATTHEW	FACILITY NUMBER: 414003012
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. 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, which poses/posed a potential health, safety or personal rights risk to children in care.
	POC Due Date: 05/18/2024
	Plan of Correction
1 2 3 4	The director stated she will complete the Pediatric First AId/ CPR course from the American Red Cross The director must submit the new Pediatric First AId/ CPR certificate to the department by the due date mentioned above.

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.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: EPISCOPAL DAY SCHOOL OF ST. MATTHEW	FACILITY NUMBER: 414003012
	VISIT DATE: 04/18/2024

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
LPAs observed bathrooms to be clean and in working condition. The sink was observed to be in working condition and not providing water warmer than 120 degrees Fahrenheit. LPAs observed that the toilets and handwashing facilities at the CCC were in safe and sanitary operating condition.

LPAs observed that all accessible classroom cabinets and drawers did not contain hazardous materials or poisons. LPAs observed that poisons, cleaning solutions, and chemicals were stored on high shelves or shelves with child safety locks to make them inaccessible to children.

LPAs observed that a fence enclosed the outdoor playground, and the equipment and furniture were in good condition. LPAs observed that the CCC did not have any pools, spas, or other types of bodies of water in the outdoor area.

LPAs observed that the CCC has a specific sleeping/resting area for children. LPAs observed that the CCC was equipped with mats and sheets.

LPAs reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information.

LPAs reviewed the files of four staff members and found that all four staff members were not current with their Pediatric First Aid/CPR certifications. After reviewing the transcripts of all four staff members, LPAs discovered that one staff member completed their twelve required Early Childhood Education units to become qualified teachers

LPAs reminded the Director that each staff member must keep their immunization records and TB test records on file.

LPAs were given a lead water report. According to the report, the lead water testing was completed in March 2020.

Page 3

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC809 (FAS) - (06/04)

Page: 3 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: EPISCOPAL DAY SCHOOL OF ST. MATTHEW	FACILITY NUMBER: 414003012
	VISIT DATE: 04/18/2024

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
Director 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.

LPA discussed the safe sleep regulations with director 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 director 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, an updated Plan of Operation that includes 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) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers

Director 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.

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

Please refer to LIC 809D for today’s citation.

Appeal Rights were given to the Director, Erin Hudec.

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 Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/18/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4