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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505833
Report Date: 03/23/2023
Date Signed: 03/23/2023 11:21:21 AM

Document Has Been Signed on 03/23/2023 11:21 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:MISSION CHILDCARE CONSORTIUM, INC.FACILITY NUMBER:
380505833
ADMINISTRATOR:SANTANA, MELANIEFACILITY TYPE:
850
ADDRESS:4750 MISSION STREETTELEPHONE:
(415) 586-6139
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 224TOTAL ENROLLED CHILDREN: 224CENSUS: 124DATE:
03/23/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Patricia HamiltonTIME COMPLETED:
11:35 AM
NARRATIVE
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Licensing Program Analyst, LPA Yee conducted a case management visit today. LPA toured and inspected all the classrooms in use and inspected the kitchen with the site director, Patricia Hamilton. LPA observed large water bottles with small disposable cups in each classroom and outside yard. There is a refrigerator in each classroom to store pre-packed snacks and lunches. The pre-packed snacks and lunches are prepared and delivered by an outside vendor each morning at 8:00 am. However, LPA observed bags of uncut fresh fruits (oranges, pears, apples) inside the refrigerator. Fresh fruits are prepared on-site in each classroom. The facet is used to wash the fresh fruits and is included in the pre-packed snacks/lunches.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection.

The facility is licensed for 224 children. Under HSC1597.16. "A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test".

See next page for type B citation. The facility needs to correct the deficiency by the due date. If chooses not to do the lead testing, the facility may request a waiver with a plan of correction in writing.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 03/23/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/23/2023
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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Document Has Been Signed on 03/23/2023 11:21 AM - It Cannot Be Edited


Created By: Jennifer Yee On 03/03/2023 at 02:16 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: MISSION CHILDCARE CONSORTIUM, INC.
FACILITY NUMBER: 380505833

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/23/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/24/2023
Section Cited
HSC
1597.16

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HSC1597.16.
(a) (1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.
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The facility needs to submit a plan of correction no later than 04-24-2023

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Based on information obtained during today's visit, the facility has not tested water for lead.

This poses a potential health, safety, or personal rights risk to persons in care.
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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.
SUPERVISOR'S NAME:Ali Zebila
LICENSING EVALUATOR NAME:Jennifer Yee
LICENSING EVALUATOR SIGNATURE:
DATE: 03/23/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/23/2023


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