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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380500487
Report Date: 06/29/2023
Date Signed: 06/29/2023 03:26:54 PM

Document Has Been Signed on 06/29/2023 03:26 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:ONE FIFTY PARKER AVENUE NURSERY SCHOOLFACILITY NUMBER:
380500487
ADMINISTRATOR:JARROD RONDEAUFACILITY TYPE:
850
ADDRESS:150 PARKER AVETELEPHONE:
(415) 221-0294
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94118
CAPACITY: 35TOTAL ENROLLED CHILDREN: 35CENSUS: 5DATE:
06/29/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:20 PM
MET WITH:Steven KongTIME COMPLETED:
03:43 PM
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On June 29, 2023 at 1:20 PM, Licensing Program Analyst (LPA) Cowan met with assistant director, Steven Kong, for a 1 Year Required Inspection. Purpose of the inspection was explained. Present, in the facility is assistant director, 5 staff, and 5 children in care. Facility is operating within its capacity, and facility is in compliance with staff / child ratio on this day. Facility operates day care Monday to Friday from 08:00 AM to 6:00 PM.

With director, LPA inspected the day care room and play yard. LPA observed facility has working smoke detector, carbon monoxide detector, fully charged fire extinguisher, and 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 is in good repair and free of any hazards.

There are first aid supplies available in the classroom. All bathrooms are in working condition. All storage containers for solid waste have fitted lids. Facility has a sufficient amount of sleeping matts available. Food preparation area is free of litter. Food is stored adequately to prevent contamination. Play yard is free of hazards. There is a sufficient amount of bark to help absorb the impact of falls. There is water available on the yard as well as in the classroom.

LPA reviewed sign in / out sheet. Facility has license and all other required documents posted and visible for the public. Facility’s last emergency drill was conducted 5/26/23 and is properly logged. At 2:05 PM, LPA reviewed the facility records. LPA reviewed 5 random children's files. Children’s files are complete with all required Licensing documents. LPA reviewed 5 staff's files. Per director, all contact information of file is current.

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.
Report continues on next page……….
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE: DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/29/2023
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: ONE FIFTY PARKER AVENUE NURSERY SCHOOL
FACILITY NUMBER: 380500487
VISIT DATE: 06/29/2023
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Site director 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.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES.
LPA referred licensee site director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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/.

Site director 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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the assistant site director, Steven Kong.

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: April Cowan
LICENSING EVALUATOR SIGNATURE:

DATE: 06/29/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023
LIC809 (FAS) - (06/04)
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