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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505210
Report Date: 03/20/2025
Date Signed: 03/20/2025 11:54:20 AM

Document Has Been Signed on 03/20/2025 11:54 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:ULLOA CHILDREN'S CENTERFACILITY NUMBER:
380505210
ADMINISTRATOR/
DIRECTOR:		WANG, CAILINGFACILITY TYPE:
840
ADDRESS:2650 42ND AVENUETELEPHONE:
(415) 759-8854
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 120TOTAL ENROLLED CHILDREN: 120CENSUS: 47DATE:
03/20/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:33 AM
MET WITH:Wang, CaiLing and Timothy LopezTIME VISIT/
INSPECTION COMPLETED:
12:00 PM
NARRATIVE
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On March 20, 2024, Licensing Program Analyst (LPA) Van conducted an unannounced annual inspection and met with the Director, CaiLing Wang, and Assistant Director, Timothy Lopez. The purpose of the inspection was explained, and access to the center was granted. This facility is a school-aged after-school program that operates in the SFUSD Ulloa Elementary School. The Ulloa School has approved the Center’s use of the tutoring room, gym, boys' and girls' restrooms, and the outdoor playground. The director, assistant director, and three teachers supervised 47 school-aged children.

The hours of operation are Monday through Friday, with the morning program running from 7:00 am to 9:30 am and the after-school program taking place from 3:30 pm to 6:30 pm, except on Wednesdays when it operates from 2:30 pm to 6:30 pm. For the afternoon program, staff members will pick up kindergarteners and first graders from their classrooms and safely escort them to the program. For older children, their teachers will walk them to the after-school program. Upon arrival, the center’s staff will check them in and count everyone to ensure all children are accounted for and safe.

All staff members present during the inspection had their criminal record clearances verified through the CDSS Guardian Background Check site and were found to have eligible clearance status.

The Assistant Director and LPA inspected the facility for potential health and safety hazards. LPA observed that the facility had a binder for signing in and out. The staff signed in the children who arrived at the center on their own. The tutoring room features age-appropriate games, books, and well-maintained learning materials. The room provides adequate ventilation and ample lighting. Each child has a basket to store their belongings. The facility has a dual centralized smoke and carbon monoxide detector and multiple fully charged fire extinguishers.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/20/2025
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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Document Has Been Signed on 03/20/2025 11:54 AM - It Cannot Be Edited


Created By: Brendon Van On 03/20/2025 at 10:05 AM
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: ULLOA CHILDREN'S CENTER
FACILITY NUMBER: 380505210

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the record review, the Center did not comply with the section cited above. Two out of five staff members did not have immunization records on file or available for review; this includes measles, pertussis, and influenza, which pose a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 04/04/2025
Plan of Correction
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Before commencing employment, the center/director must ensure that all staff members' immunization records are complete and on file. The director will obtain the immunization records of the two staff members and include them in the personnel file by the due date of 4/4/2025. A follow-up visit will be conducted to confirm that any deficiencies have been addressed.
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the record review, the Center did not comply with the section cited above. Four out of five staff members' mandated reporter training was not up to date, which poses a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 04/04/2025
Plan of Correction
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The Center/Director is responsible for ensuring that all staff complete Mandated Reporter Training every two years. The record of completion must be available for inspection. The Director will ensure that all staff members finish the training by April 4, 2025. A follow-up visit will be conducted to confirm that any deficiencies have been addressed.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Garfield Leung
LICENSING EVALUATOR NAME:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 03/20/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/20/2025


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: ULLOA CHILDREN'S CENTER
FACILITY NUMBER: 380505210
VISIT DATE: 03/20/2025
NARRATIVE
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The facility has no pools, spas, or other bodies of water. All cleaning solutions, poisons, and other dangerous chemicals are inaccessible to children. LPA noted that the unused electrical outlets have covers installed. All bathrooms, toilets, and sinks are clean and well-sanitized. All solid waste bins have suitable tight-fitted lids.

The outdoor playground area is in good repair and completely fenced for supervision. The kindergarteners have a separate playing area with climbs, slides, and monkey bar structures. The play structure is age-appropriate and in good condition, with soft rubber cushioning underneath for accidental falls.

LPA reviewed the records of five children and five staff members. The center maintained complete records for the children, including authorized representatives' names, addresses, and phone numbers. Staff members' records indicated that all individuals requiring caregiver background checks had undergone criminal record checks and child abuse index clearances or exemptions. Several teachers held valid CPR certificates. However, it was noted that four out of five staff members did not possess up-to-date mandated reporter training certificates, and two out of five staff members lacked their measles, pertussis, and influenza vaccinations.

LPA observed that the facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, and Notification of Personal Rights).

The Assistant Director stated that Fire and Earthquake drills are conducted monthly, typically in conjunction with the Ulloa School drills. The last drills were held on 2/19/2025.

The Assistant 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.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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: ULLOA CHILDREN'S CENTER
FACILITY NUMBER: 380505210
VISIT DATE: 03/20/2025
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Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Assistant Director was informed about Mandated Reporter training AB 1207. The Mandated Reporter AB 1207 training must be completed every two years by the Licensee and for all staff hired. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Assistant Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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 childcare 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).

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
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: ULLOA CHILDREN'S CENTER
FACILITY NUMBER: 380505210
VISIT DATE: 03/20/2025
NARRATIVE
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The Center has a written attestation approved on October 24, 2023. The written attestation indicated that the Center has no water outlets used or made accessible to children to use for food preparation or drinking water and, therefore, is not required to test any water outlets per Health and Safety Code 1597.16 at this time. The Center provides water bottles to children indoors and outdoors. Per the Assistant Director, the Center purchases cases of individual water bottles directly from the grocery store. LPA observed five to six cases of 24 bottles stored in the staff lounge available for children.

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

See LIC 809D for deficiency cited during the inspection.

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

An exit interview was conducted, appeals right, and the report was reviewed with the Assistant Director, Timothy Lopez.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 03/20/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025
LIC809 (FAS) - (06/04)
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