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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504354
Report Date: 03/18/2026
Date Signed: 03/18/2026 02:28:48 PM

Document Has Been Signed on 03/18/2026 02:28 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SFUSD-ZAIDA T. RODRIGUEZ (EES) PRESCHOOLFACILITY NUMBER:
380504354
ADMINISTRATOR/
DIRECTOR:		DEMARCO, FRANCINEFACILITY TYPE:
850
ADDRESS:2950 MISSION STREETTELEPHONE:
(415) 695-5842
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 60TOTAL ENROLLED CHILDREN: 60CENSUS: 22DATE:
03/18/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Marilyn Dunn, Tiffany O'Neal TIME VISIT/
INSPECTION COMPLETED:
02:35 PM
NARRATIVE
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On 3/18/2026 at 9:00PM., Licensing Program Analyst (LPA), Luis Gomez met with Substitute Administrative Assistant, Marilyn Dunn. The purpose of today's visit was explained and was for an unannounced- annual random inspection. This facility is a licensed preschool program. Principal, Tiffany O'Neal arrived during inspection. Present was the principal and 6 staff supervising 22 children. The children present have been signed in by guardians. The facility’s day and hours of operation are Monday- Friday, 7:30AM- 5:30PM. The preschool program utilizes 2 classrooms (#3, #4) and a shared outdoor play yard. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 9:15AM., LPA observed the following: classrooms were neat and orderly, with age-appropriate learning materials available for the children. The classrooms have labeled cubbies for storage of belongings.

The children’s furniture and playthings inspected were in good repair, free of sharp corners or splinters. LPA observed several tables and chairs inside classrooms, scaled to the appropriate size. The school’s books, playthings, and supplies inspected were in like-new condition.

The children’s bathrooms were maintained clean with fixtures in operating condition. The bathrooms had adequate supplies for handwashing. The trash bins have tight fitted cover installed.

The children's medication was reviewed during inspection. LPA reminded principal to ensure IMS plan is stored in classrooms, written approval and instructions from child's physician. (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/18/2026
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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Document Has Been Signed on 03/18/2026 02:28 PM - It Cannot Be Edited


Created By: Luis Gomez On 03/18/2026 at 12:15 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: SFUSD-ZAIDA T. RODRIGUEZ (EES) PRESCHOOL
FACILITY NUMBER: 380504354

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/18/2026

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238.2(d)(1)
Outdoor Activity Space
(d) The surface of the outdoor activity space shall be maintained: (1) In a safe condition for the activities planned.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 10:00AM., Based on observation, LPA confirmed excessive leaves/ debris on ground in the outside play area and inside storage containers. This poses a potential risk to the health and safety of children in care.
POC Due Date: 04/01/2026
Plan of Correction
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Facility will remove leaves/ debris, (dust, dirt build-up) from outdoor play yard and storage containers. Moreover, facility will submit plan to the department for scheduled daily inspection of space and removal debris prior to use, due date: 4/1/2026.

Proof of correction will be submitted to the Department via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Luis Gomez
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 03/18/2026
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/18/2026


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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SFUSD-ZAIDA T. RODRIGUEZ (EES) PRESCHOOL
FACILITY NUMBER: 380504354
VISIT DATE: 03/18/2026
NARRATIVE
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(PAGE 2)
For nap/ scheduled rest, the facility has stackable cots available for each child in care. Per teacher, the napping supplies (blankets, linens) are washed weekly by guardians. The classrooms had adequate ventilation, were well lit and maintained at a comfortable temperature. This facility has a functioning telephone service; carbon monoxide (CO) detector (Built-in); and fire extinguisher (2A10BC), fully charged.

The school district provides daily snack and lunch services for children in care. The menu (march) was observed posted in the main office. The food preparation/ kitchen area was reviewed, and was observed clean, free of debris or rubbish. The food inspected (dry snacks) was current and had been properly stored.

During inspection, LPA reviewed the shared outdoor play yard. LPA observed area was completely enclosed, with a shaded rest available and several chairs. The sandboxes were observed without any hazardous items. Per director, the sandbox is covered with tarp in the evening. The climbing structure was observed properly anchored. The area has absorbent material (rubber squares) installed underneath structure.

At 10:00AM., Based on observation, LPA confirmed excessive leaves/ debris on ground in the outside play area and inside storage containers.

LPA advised principal to install padlocks on storage containers with gardening equipment and remove accessible potting soil from the on-limit areas. Advisory Note: Technical Violation (LIC9102TV) was issued.

For accessible drinking water, refillable water bottles are brought to site by the guardians, for children to have as they wish.

At 10:45AM., LPA reviewed facility records including samples of children's and personnel files. The personnel files reviewed contained teacher: Proof of Qualifications; Personnel Record (LIC501); Notice of Employee Rights (LIC9052); and the Signed Acknowledgement to Report Suspected Child Abuse (LIC9108).

LPA reminded principal to ensure staff's proof of complete mandated reporter training course (AB1207), and immunization record in stored in the facility files for department review.

The children’s files were reviewed and included clients: Consent for Medical Treatment (LIC627); Identification of Emergency Information; Immunization Record; and the guardian- signed Personal Rights (LIC613A), and Notification of Parents Rights (LIC995A) forms.

The director's cardiopulmonary resuscitation/ first aid certification was current, expiring: 9/2027. The school’s disaster logs show emergency drills (Fire drill) was performed on: 1/27/2026. The required postings are in main office and include the: License; Emergency Disaster Plan (LIC610); Notification of Parent’s Rights (LIC995A); Seat Belt Safety Laws; Personal Rights Form; and ALE Lead testing results. (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SFUSD-ZAIDA T. RODRIGUEZ (EES) PRESCHOOL
FACILITY NUMBER: 380504354
VISIT DATE: 03/18/2026
NARRATIVE
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Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed childcare centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test. LPA has verified that lead testing procedure was completed in accordance with the Written Directives outlined in PIN 21-21- CCP.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/.

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.

Based on today's inspection, deficiencies were observed in the areas evaluated, according to Title 22, Division 12, Chap. 1 Ca. Health and Safety Code of Regulations and cited on LIC809D. An exit interview was conducted, including review of facility evaluation report (FER), and plan for correction with Principal, Tiffany O’Neal. Signature of this form acknowledges receipt of these documents.

This report and rights to comment were discussed. This report must be available in the facility file for public review. The Notice of site visit was provided and must remain posted for 30 days. Principal was advised for additional questions to contact the San Bruno Regional Office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 03/18/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/18/2026
LIC809 (FAS) - (06/04)
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