214005608-10-25-2023-05-CC-HLEG-CWXU5Z-20231025151735

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005608
Report Date: 10/25/2023
Date Signed: 10/25/2023 03:17:43 PM

Document Has Been Signed on 10/25/2023 03:17 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:	OLD FIREHOUSE SCHOOL		FACILITY NUMBER:	214005608
ADMINISTRATOR:	CHELSEA BRYSON		FACILITY TYPE:	830
ADDRESS:	1510 FIFTH AVENUE		TELEPHONE:	(415) 419-5479
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94901
CAPACITY: 13	TOTAL ENROLLED CHILDREN: 13	CENSUS: 4	DATE:	10/25/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Chelsea Bryson		TIME COMPLETED:	03:30 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 10/25/2023, Licensing Program Analyst (LPA) Hanson Leong, made an unannounced annual visit to the child daycare facility listed above. This facility also operates a preschool program under license number 214005607. The LPA was granted entry by the Director, Chelsea Bryson. The LPA explained the purpose of the visit to Ms. Bryson. The LPA observed 2 staff members supervising 4 infants. All individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The facility is operating within its capacity and in accordance with the required ratio of staff to children. The LPA and Ms. Bryson both performed comprehensive inspections of the facility to look for possible threats to health and safety. The LPA observed that the facility maintains an electronic record of when children sign in and out, and the number of parent signatures matches the number of children enrolled for the day. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA observed that the playground equipment and outdoor furnishings are in very good shape. The LPA did not observe any infants in the outdoor play area. The LPA found that the facility is operating within their outside waiver capacity of 5 infants. The LPA found that the facility did not have any pools, spas, or other types of bodies of water of any kind. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order. According to Ms. Bryson, the facility does not house any firearms or other types of weapons. *See Page 2*

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

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: OLD FIREHOUSE SCHOOL	FACILITY NUMBER: 214005608
	VISIT DATE: 10/25/2023

NARRATIVE

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The LPA observed a designated area for children to sleep or rest quietly. The area has sufficient sleeping equipment for each child, and all mattresses and bedding are stored in the appropriate location. According to Ms. Bryson, parents are responsible for providing blankets for their child. In addition, bedding and napping equipment are washed and sanitized twice a week. The LPA reminded Ms. Bryson that emergency exits must always remain clear, and that cots and cribs cannot be situated in a manner that blocks emergency exits.

According to Ms. Bryson, parents provide disposable diapers and wipes for their own children. The facility has one designated changing table with at least one inch of cushioning and disposable paper coverings. Additionally, the borders of the changing tables are raised by at least 3 inches to prevent accidents. After each use, disposable wipes are used to sanitize the area. The LPA reminded Ms. Bryson that the diaper changing station and sink must be reserved solely for their intended purpose. The LPA reminded Ms. Bryson that the diaper changing tables and sink may not be used for food preparation or as an area to hold classroom materials or classroom activities.

The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities)

The LPA reviewed both the children's and staff records. The LPA reviewed the records of the 4 children and found immunization information, along with the names, addresses, and phone numbers of each child's authorized representative. The LPA reviewed the sleeping records of the 4 children under the age of two and determined that the data was properly recorded The LPA reviewed the records of the 2 staff members and found that 1 staff member possesses a valid Pediatric First Aid/CPR certification. The LPA also found that both staff members possess up-to-date certification in Mandated Reporter training.

The LPA reviewed the facility's emergency drill log. According to the facility's emergency drill log, the last earthquake drill was carried out on 9/19/2023.

***See Page 3***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

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: OLD FIREHOUSE SCHOOL	FACILITY NUMBER: 214005608
	VISIT DATE: 10/25/2023

NARRATIVE

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Ms. Bryson 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.

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).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

LPA discussed the safe sleep regulations with Ms. Bryson 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 Ms. Bryson 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
***See Page 4***

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

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: OLD FIREHOUSE SCHOOL	FACILITY NUMBER: 214005608
	VISIT DATE: 10/25/2023

NARRATIVE

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Ms. Bryson 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.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

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

No deficiencies were cited today under CCR, Title 22, Div. 12.

A copy of today’s report was given to Chelsea Bryson. The Notice of Site Visit was given to Chelsea Bryson and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and report was reviewed with Chelsea Bryson.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2023

LIC809 (FAS) - (06/04)

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