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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504386
Report Date: 05/21/2024
Date Signed: 05/21/2024 11:55:50 AM

Document Has Been Signed on 05/21/2024 11:55 AM - 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:CCFC- 31ST AVENUEFACILITY NUMBER:
380504386
ADMINISTRATOR/
DIRECTOR:		MANIJEH M. JAFARFACILITY TYPE:
850
ADDRESS:750 31ST AVENUETELEPHONE:
(415) 668-7863
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY: 43TOTAL ENROLLED CHILDREN: 16CENSUS: 15DATE:
05/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Manijeh JafarTIME VISIT/
INSPECTION COMPLETED:
12:25 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Site Director, Manijeh Jafar, and 3 staff. LPA explained the purpose of the inspection to the Site Director. All staff have fingerprint clearance. There were 15 children with 3 teachers plus a Site Director present. The facility is located at Richmond District Neighborhood Center that is a combination center; it has 2 preschool programs under 2 different license numbers and addresses (30th Avenue & 31st Avenue) at the same center. The center has a different entrance for each program. The facility's operation hours are Monday to Friday from 7:30 AM to 5:30 PM. The facility has locked the main doorway to prevent people from entering the facility freely, so it has a doorbell with a security camera by the main entrance to have the Parents or visitors buzzing for entry. The facility runs the preschool program in 2 big connected classrooms. LPA inspected the facility for health and safety hazards. The facility was clean and in order, temperature and lighting were adequate, and the toxins and harmful objects were made inaccessible to the children. The center also has a children's bathroom room with 3 toilets & 3 sinks plus an extra big sink with 2 faucets outside the children's bathroom available for the children. There was a staff bathroom available next to the children's bathroom for the adult. The facility had a Dyson fan to provide better air circulation in the center by the cubbies area. The facility had the right amount of cubbies with children's names available for the children to store their personal belongings by the main entrance. There were plenty of age-appropriate toys, books, learning materials & equipment, sand & water tables, and children's furniture that were in good condition and repaired. First Aid supplies were available indoors and outdoors. All electrical outlets were covered. LPA did not observe any sharp corners in the facility during the inspection. The facility provides breakfast, AM/PM Snacks, and lunch to the children. All lunches were delivered from the main kitchen to the facility's food preparation area daily. Staff prepare the lunches before serving them to the children in the food preparation area. LPA inspected the food preparation area that was next to the office. The area was clean and in order. The food waste bin had a tight lid. The facility had milk and soy milk that were kept in the refrigerator available for the children daily. The facility posted a weekly menu by the main entrance. Drinking water was served in the water pitchers with cups in the classrooms. The center has 2 outdoor play yards (left & right side of the building) that are shared with another center (CCFC-30th Avenue) by schedule daily. The outdoor play yards were completely fenced. They have slide & climbing structures, sandbox areas, garden beds along the fences, age-appropriate outdoor toys, and ride-on toys available for the children. The facility also installed soft cushioning on the entire ground in both play yards to prevent injury. Per the Site Director, there were 2 children on special medication. LPA inspected the storage of the medication and the documents during the inspection. All staff had current CPR/First Aid training & Child Abuse Mandated Reporter Training that will expire on 10/25 & 7/24. LPA reviewed the children and staff files, reviewed the sign-in/out sheet, and obtained a copy of the current children's roster during the inspection. The facility conducts disaster drills monthly and logs properly. The facility passed the Lead Water Test that has to be done every 5 years.

continuous in LIC809C

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/21/2024
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 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: CCFC- 31ST AVENUE
FACILITY NUMBER: 380504386
VISIT DATE: 05/21/2024
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Criminal Record Clearance - Child Care Centers Licensee [or facility representative] 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.

Lead Testing – Child Care Centers (CCC) CCC COMPLETED TESTING AND 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 21-21.1CCP). LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. PIN 22-05-CCP Page Four For the following scenarios use the below un-bolded language: • CCC COMPLETED TESTING AND IS IN THE PROCESS OF REMEDIATING LEAD EXCEEDANCES, or • CCC COMPLETED SAMPLING BUT THE TEST RESULTS ARE NOT YET AVAILABLE, or • CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE, or • CCC TESTING DEADLINE HAS NOT PAST LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

Incidental Medical Services (IMS) - Child Care Centers
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-carecenters/
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
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: CCFC- 31ST AVENUE
FACILITY NUMBER: 380504386
VISIT DATE: 05/21/2024
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Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the Site Director, Manijeh Jafar.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 05/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/21/2024
LIC809 (FAS) - (06/04)
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