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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004288
Report Date: 03/06/2023
Date Signed: 03/06/2023 01:13:10 PM


Document Has Been Signed on 03/06/2023 01:13 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 ONEFACILITY NUMBER:
414004288
ADMINISTRATOR:WIN, KAY K AND WIN, PHYU NFACILITY TYPE:
850
ADDRESS:164 SCHOOL STREETTELEPHONE:
(650) 994-2020
CITY:DALY CITYSTATE: CAZIP CODE:
94014
CAPACITY:20CENSUS: 5DATE:
03/06/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:15 AM
MET WITH:Phyu Win & Kay WinTIME COMPLETED:
01:30 PM
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On March 6, 2023 at approximately 11:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with director, Phyu Win, and explained the purpose of the visit. Present during LPA's visit included director, lead teacher, and 5 enrolled children (all preschool age). Facility is operating within capacity limits and ratio during LPA's visit.

All staff working at facility have fingerprint clearance on file. Hours of operation are Monday to Friday 7:30am to 5:30pm.

LPA inspected the day care areas for health and safety hazards. Facility is equipped with a variety of age appropriate toys and materials that were in good working condition. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers and/or blocked by furniture. There is sufficient space for children's belongings that is located in the lobby, labeled with children's individual names.

LPA did not observe any hazards or poisons that were accessible in day care areas. LPA observed cleaning solutions, poisons and other chemicals to be stored inaccessible to children in facility's high shelves. Facility is equipped with multiple fire extinguishers, fully stocked first aid cabinet, and a working carbon monoxide detector. Facility includes a kitchen that is made off limits to children with a child safety gate.

Children's restrooms were observed to be clean and in proper working condition. LPA observed bathroom to have appropriate toileting equipment and sanitation products. Garbage bins were observed to have tight fitting lids.

Drinking water is made available with a filtered water station located in classroom. Classroom is also equipped with a sink that is accessible to children. LPA observed classroom sinks to also be equipped with appropriate sanitation materials.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/06/2023
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: MILESTONE ACADEMY PRESCHOOL ONE
FACILITY NUMBER: 414004288
VISIT DATE: 03/06/2023
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Facility uses mats for napping children. LPA observed children's sheets to be appropriately stored in children's designated cubbies, located in lobby of facility.

All licensing documentation and information is properly posted in front entrance of center. Children are signed in and out of facility with children's authorized representatives' written signatures. During LPA's visit, all children were properly signed into program.

Drinking water is made available, indoors and outdoors, with children's individual water bottles. Facility refills children's water bottles through filtered water pitches. Outdoor area is entirely enclosed with an at least 5 ft. high fence. LPA did not observe any spas, pools or bodies of water on property. Outdoor area is equipped with a garbage bin with a tight fitting lid. LPA observed outdoor area to be equipped with a variety of outdoor equipment that was observed to be age appropriate and in good working condition. Outdoor area includes a play structure with resilient padding underneath.

Facility conducts emergency disaster drills that are properly documented and logged. Last emergency disaster drill was conducted 02/15/2023. LPA reviewed 5 children's records (whom were present during visit). Children's files were observed to be complete with emergency identification information on file. LPA reviewed director and lead teacher's files, which were also complete. Both director and lead teacher have current CPR certifications that will expire 01/2024 and 03/2024. Both director and lead teacher have a current Mandated Reporter certification that will expire 03/2024. Both director and lead teacher have required immunizations that were made available for review during LPA's visit.

Director 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.

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.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023
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: MILESTONE ACADEMY PRESCHOOL ONE
FACILITY NUMBER: 414004288
VISIT DATE: 03/06/2023
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Director 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (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 comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director/co-licensee, Phyu Win.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2023
LIC809 (FAS) - (06/04)
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