214005435-7-3-2023-05-CC-NGAA-CTDTU4-20230703150144

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005435
Report Date: 07/03/2023
Date Signed: 07/03/2023 03:01:54 PM

Document Has Been Signed on 07/03/2023 03:01 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:	LIEN, KRISTEN A.		FACILITY NUMBER:	214005435
ADMINISTRATOR:	LIEN, KRISTEN A.		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(415) 320-5891
CITY:	NOVATO	STATE: CA	ZIP CODE:	94947
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 0	DATE:	07/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Kristen Lien		TIME COMPLETED:	03:15 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 6/23/23, LPA Garcia attempted to visit licensee for unannounced annual inspection. LPA was greeted by the Licensee's husband and told LPA that the day care is closed for today because his wife is feeling sick. Per Licensee's husband, licensee has been up all night and is currently resting. The licensee sent out text messages to all the families last night about today's closure. On July 3, 2023 at 1:00PM, Licensing Program Analyst (LPA) Nathan Garcia returned and arrived at the facility to conduct an unannounced Annual Inspection and met with the Licensee, Kristen Lien. Purpose of the inspection was explained. There were no children present at the time of visit. Per Licensee the home is closed for the 4th of July holidays. LPA verified the background check clearance of the adults working or living in the home. The hours of operation are Monday through Friday, 07:30 AM - 5:30 PM. Licensee provides breakfast, AM/PM snacks and lunch. The water is provided by the licensee through filtered tap water. Daycare areas: 2 Living room, bathroom and kitchen Off Limit areas: 3 bedroom, and 1 bathroom, the rest of the house. LPA observed that off limit areas were properly barricaded and made inaccessible to the children in care. LPA and Licensee inspected the entire childcare area for Health and Safety hazards. There are multiple carbon monoxide and smoke detectors located in each room. LPA performed the tests to check the functionality of the detectors. One fully charged fire extinguisher of size 3A40BC was also available in the home, located in the kitchen. First Aid kit is fully stocked and accessible, located all over the childcare. Licensee states, there are guns in the home locked in the safe, unloaded and with gun locks on them. The licensee has pet dogs in the house. Per licensee, the dogs do not interact with the children and the parents have signed it on their admission agreements. *continue to page 2*

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 06/23/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/23/2023

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: LIEN, KRISTEN A.	FACILITY NUMBER: 214005435
	VISIT DATE: 07/03/2023

NARRATIVE

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LPA observed that the house is in good repair and free of hazards with proper temperature and ventilation and lighting. The play area is clean, padded/carpeted and in good condition. LPA observed that there are variety of age-appropriate toys, books, and other learning materials available in the home. Electric outlets have proper covers and a working phone is on site. The Licensee has 'DC Insurance' available.

All posting requirements are met and posted near the childcare entrance. Licensee does have valid CPR/First Aid Certificate, expiring 1/2024. Mandated reporter training certificate is valid and will expire 6/2/2025. LPA reviewed facility records. Per Licensee, the husband and son helps her with the facility on Mondays and Fridays. Both individuals have immunization records on file. 1 child record was reviewed during the visit. All required files are valid and present. The facility has conducted recent emergency drills on 6/5/23, every month.

Licensee was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

Per Licensee, there is 1 child enrolled with any allergies with EpiPen. Incidental Medical Services (IMS) policy was discussed. For IMS information 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: on see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing IMS must be submitted to the www.ada.gov/childqanda.htm.

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee 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.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

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: LIEN, KRISTEN A.	FACILITY NUMBER: 214005435
	VISIT DATE: 07/03/2023

NARRATIVE

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***page 3 continued***
LPA reviewed AB 1207 with the Licensees. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online atwww.mandatedreporterca.com. Effective July 1, 2020, Licensees must have proof of completion of EMSA certified lead poison training if applying for a change of location or capacity change to an existing license.

LPA encouraged the Licensee to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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/process.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource.

LPA also informed licensee 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.

A copy of this report was given to the Licensee and a site visit notification must be posted for 30 days.

>No Deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

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

Exit interview conducted and report was reviewed with the licensee, Kristen Lien.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:	DATE: 07/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/03/2023

LIC809 (FAS) - (06/04)

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