414004137-5-1-2023-05-CC-CQUO-CRES6V-20230501133633

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004137
Report Date: 05/01/2023
Date Signed: 05/01/2023 01:36:41 PM

Document Has Been Signed on 05/01/2023 01:36 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:	JOHN F. KENNEDY ELEMENTARY		FACILITY NUMBER:	414004137
ADMINISTRATOR:	PACE, KENNETH		FACILITY TYPE:	850
ADDRESS:	785 PRICE STREET		TELEPHONE:	(650) 991-1239
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94014
CAPACITY:	24	CENSUS: 20	DATE:	05/01/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:10 AM
MET WITH:	Kenneth Pace		TIME COMPLETED:	01:30 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 1, 2023 at approximately 11:10am, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced, annual inspection. LPA met with site supervisor, Kenneth Pace, and explained the purpose of the inspection. Preschool program operates on John F. Kennedy Elementary School in classroom #32. Upon LPA's arrival, children were having lunch and preparing for nap time. Present during LPA's visit included site supervisor, 2 teaching staff, and 20 preschool children. Facility is operating within capacity limits and ratio during LPA's visit. All staff are fingerprinted through Jefferson Elementary school district. Program operates Monday through Friday 8:15am to 2:45pm. LPA inspected the preschool classroom and outdoor area for health and safety hazards. LPA observed classroom to have a variety of toys and materials that were in good working condition. Children's furniture and equipment were observed to be age appropriate. Storage for children's belongings is located inside large cabinet in classroom, that is labeled with each child's individual names. LPA observed children's personal materials and sheets to be stored in their individual cubbies, appropriately stored. Classroom is equipped with multiple fire extinguishers and an emergency backpack. A fire alarm system is implemented by school district. Per site supervisor, carbon monoxide detector is installed in high ceilings in classroom. LPA observed detectors in classroom high ceilings. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers and/or blocked by furniture. Cleaning solutions, poisons and other chemicals were observed to be inaccessible to children in classroom's high shelves. Classroom includes two sinks and a separate restroom with an additional sink, that were all in proper working condition. Sinks do not provide water that is warmer than 120 degrees Fahrenheit. LPA observed bathroom to be in proper working condition, equipped with appropriate sanitation products. (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: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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: JOHN F. KENNEDY ELEMENTARY	FACILITY NUMBER: 414004137
	VISIT DATE: 05/01/2023

NARRATIVE

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Outdoor area is located directly outside preschool classroom. Per site supervisor, playground is shared with multiple programs. LPA observed outdoor waiver to be properly posted and maintained.

LPA observed outdoor area to be fully enclosed with an at least 4 ft. high fence. Outdoor area includes a play structure that was in good working condition. Play structure includes resilient padding underneath. Drinking water is available to children, indoors and outdoors, with an accessible water pitcher and cups. Water pitcher is refilled at center.

Preschool program currently provides a food service that is through the school district . Food is prepared in elementary school kitchen, children eat in school multipurpose area.

LPA observed preschool program to use 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 all required licensing documents to be posted and visible for review. Last emergency disaster drill was conducted 03/27/2023. Emergency drills are conducted and documented at least once every six months.

LPA reviewed six random children's files. Children's files were complete with a record of emergency identification information on file. Site supervisor's CPR/First Aid is current and will expire 01/2024.

Site supervisor was informed 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.

Site supervisor 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.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

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: JOHN F. KENNEDY ELEMENTARY	FACILITY NUMBER: 414004137
	VISIT DATE: 05/01/2023

NARRATIVE

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Site supervisor was reminded that all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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. 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 site supervisor, Kenneth Pace.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2023

LIC809 (FAS) - (06/04)

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