214005379-8-27-2024-05-CC-NGAA-D8JUSM-20240827155033

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005379
Report Date: 08/27/2024
Date Signed: 08/27/2024 03:50:41 PM

Document Has Been Signed on 08/27/2024 03:50 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:	ANDREWSCAMPS		FACILITY NUMBER:	214005379
ADMINISTRATOR/ DIRECTOR:	LEWIS, OLIVIA		FACILITY TYPE:	840
ADDRESS:	400 TAMAL PLAZA #401A		TELEPHONE:	(415) 446-8946
CITY:	CORTE MADERA	STATE: CA	ZIP CODE:	94925
CAPACITY: 96	TOTAL ENROLLED CHILDREN: 96	CENSUS: 44	DATE:	08/27/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	01:37 PM
MET WITH:	Katie/Andrew Frierson		TIME VISIT/ INSPECTION COMPLETED:	04:15 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 August 27, 2024, Licensing Program Analyst (LPA) Garcia arrived at the facility and met with school age program director, Katie Frierson and later joined by owner/licensee, Andrew Frierson for an unannounced required inspection of the facility. Purpose of the inspection was explained. There were 7 children in care and there were a total of 7 teachers in the facility during the visit. More children arrived at the facility totalling to 44 children in care. Facility operates day care program Monday through Friday from 12:00 PM through 6:00 PM.

LPA inspected day care rooms and the outdoor space. LPA observed facility has combined smoke/fire and carbon monoxide detector, multiple fully charged fire extinguisher model 3A40BC located in classrooms/hallways. LPA tested the functionality of the detectors. The facility has a working telephone on site. All cleaning solutions, poisons, and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age-appropriate furniture. Facility floor and rugs are in good repair and free of any hazards.

There are first aid supplies available in the classroom. The bathroom is in working condition, LPA checked sinks and toilets. Individual items provided by the parents are labeled and stored appropriately. Per Andrew, the children bring snacks from school or home. The facility also has emergency snacks for children. Water is provided through water fountains, refilled as needed. All food is stored properly to avoid contamination. LPA observed that there are a variety of toys/books for the children to play.

LPA observed outdoor areas has a garden and age appropriate play structures are free from health and safety hazards. The outdoor area has shaded areas for the children to rest. The outdoor areas has a trampoline and sports equipment to use. There are also sheds/bins and storage areas for the toys when they're not being used.

***page 2 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

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

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: ANDREWSCAMPS	FACILITY NUMBER: 214005379
	VISIT DATE: 08/27/2024

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 continued***

CCC COMPLETED TESTING AFTER THE DEADLINE BUT NO LEAD EXCEEDANCES:

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

Based on record review and interview, the facility completed the lead water testing on April 6, 2023, without any exceedances. The lead water testing was completed after the deadline of January 1, 2023. The facility will cited for a Type B deficiency for not completing the test in a timely manner. The deficiency will be cleared during the visit. The LIC forms associated with the lead water testing were gathered.

According to staff, the facility is using paper for sign in/out. Facility has license and all other required documents posted and visible for the public. Facility has an emergency drill log and last drill was conducted on February 1, 2024. Per staff, drills are done at least every 3 months rotating them between fire and earthquake drills and lock down drills.

LPA reviewed the facility records. LPA reviewed 3 children's file during the visit. LPA reviewed 3 staff files with qualifying requirements such as ECE Units, CPR and Mandated Reporter Training. During LPA records review, Director provided LPA LIC 9182 to transfer background clearance for a staff member due to incorrect input of facility number during livescan.

The 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.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare 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.

***Page 3 for continuation***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

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: ANDREWSCAMPS	FACILITY NUMBER: 214005379
	VISIT DATE: 08/27/2024

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 Continuation***

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file.
LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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.

According to staff, there are no children with allergies.
Incidental Medical Services – IMS. 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. 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

Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

Type B deficiency for not completing lead water testing before the January 1, 2023 deadline. Deficiency will be cleared during the visit.

A copy of this report was given with the “Notice of Site Visit” to the staff. A Notice of Site Visit must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed and signed by director/owner, Andrew Frierson.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 08/27/2024 03:50 PM - It Cannot Be Edited

Created By: Nathan Garcia On 08/27/2024 at 03:45 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: ANDREWSCAMPS	FACILITY NUMBER: 214005379
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/27/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on [(observation) (interview) (record review)], the licensee did not comply with the section cited above which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 08/28/2024
	Plan of Correction
1 2 3 4	The facility completed lead water testing on 4/26/23. The deficiency will be cleared during the visit. The lead water testing results show no exceedances.

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

LICENSING EVALUATOR NAME:

Nathan Garcia

LICENSING EVALUATOR SIGNATURE:

DATE: 08/27/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/27/2024

LIC809 (FAS) - (06/04)

Page: 4 of 4