380505563-8-20-2024-05-CC-WLYY-D8BQSY-20240820122619

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380505563
Report Date: 08/20/2024
Date Signed: 08/20/2024 12:26:37 PM

Document Has Been Signed on 08/20/2024 12:26 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:	KAI MING HEAD START-DR. T. KONG LEE CENTER		FACILITY NUMBER:	380505563
ADMINISTRATOR/ DIRECTOR:	BANDI PARK		FACILITY TYPE:	850
ADDRESS:	950 POWELL STREET		TELEPHONE:	(415) 982-4777
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94108
CAPACITY: 20	TOTAL ENROLLED CHILDREN: 20	CENSUS: 7	DATE:	08/20/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Shuzhen (Sally) An		TIME VISIT/ INSPECTION COMPLETED:	12:45 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 August 20, 2024 at approximately 9:15am, Licensing Program Analyst (LPA Ly conducted an Unannounced Annual Visit and met with Site Manager, Shuzhen (Sally) An during the visit. Purpose of the inspection was explained. There are 7 children 4 classroom staff caring for the children in the classroom present during the visit. Teacher to child ratios were met on this day. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors and a carbon monoxide detector are observed during the inspection. Facility uses electronic system for parents to sign their children in and out of the system. All children were signed into the system. LPA and Site Manager inspected the center for Health and Safety Hazards. There are no pools, spas or other bodies of water on the premises. Per the Site Director, there are no firearms or weapons in the center. Adequate first aid supplies are available. Sick children will be separated from the group while waiting for parents to pick up. All cleaning supplies and other potentially harmful items are stored inaccessible to the children. Medications are stored in backpack inaccessible to children. LPA reviewed medication procedures with staff. Furniture and equipment are in good condition, free from loose, sharp or pointed parts. Children's bathrooms are in working order with adequate supplies. There are separate bathrooms on site for adults. The center provides breakfast, lunch and afternoon snack. Chefable is the vendor that cater the children's meals. Weekly Menu is available and visible to parents. All solid waste storage containers have tight fitting lids. Drinking water is provided indoor and outdoor with disposable cups. Per Site Manager, program has just started and is planning to conduct disaster drill tomorrow 08/21/2024. A random sample of children's files were reviewed and found children's files have emergency contact information, required licensing forms and immunization records. Staff files were also reviewed. Staff files were also found to be complete. At least one staff have current Pediatric First Aid and CPR, required training are up to date and immunization record are on file. Facility has posted all the required licensing forms in a prominent visible location. CONTINUED>>>...PAGE 2...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024

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: KAI MING HEAD START-DR. T. KONG LEE CENTER	FACILITY NUMBER: 380505563
	VISIT DATE: 08/20/2024

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
26
27
28
29
30
31
32

Page 2...

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.

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.

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.

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

CONTINUED>>>...PAGE 3...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024

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: KAI MING HEAD START-DR. T. KONG LEE CENTER	FACILITY NUMBER: 380505563
	VISIT DATE: 08/20/2024

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
26
27
28
29
30
31
32

Page 3...

Facility Representative 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.

Facility was also informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

LPA discussed Child Abuse Mandated Training AB1207 with the Site Manager. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Site Manager. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The site manager was advised that a free one hour online course is available on the Department of Pesticide Regulation's Web site: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report and appeal rights were discussed and left with Director whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:	DATE: 08/20/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/20/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3