<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380505931
Report Date: 08/14/2024
Date Signed: 08/14/2024 11:23:20 AM

Document Has Been Signed on 08/14/2024 11:23 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SFUSD-JOHN MUIR ECIA (EES) PRESCHOOLFACILITY NUMBER:
380505931
ADMINISTRATOR/
DIRECTOR:		SARA LIEBERTFACILITY TYPE:
850
ADDRESS:380 WEBSTER STREETTELEPHONE:
(415) 241-6339
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94117
CAPACITY: 36TOTAL ENROLLED CHILDREN: 36CENSUS: 0DATE:
08/14/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Principal, Don FrazierTIME VISIT/
INSPECTION COMPLETED:
11:35 AM
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 8/14/2024, at approximately 9:05AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Principal Don Frazier (D1) and explained the purpose of the visit. There were no children present during today’s visit. The facility’s operating hours are from 8:20AM to 2:50PM.

LPA and D1 inspected the facility for any health or safety hazards. The facility is located on the premises of John Muir Elementary School. The facility uses Rooms 106 and 110, in addition to an outdoor play area. LPA observed there to be a fire alarm system running throughout the building. LPA observed that a 2A10BC fire extinguisher present in Room 110 was not fully charged. LPA observed that the carbon monoxide detectors present in the classrooms were not functional. D1 stated that the carbon monoxide detectors would have their batteries replaced. Poisons, cleaning detergents, and other chemicals were observed to be stored in locked cabinets to be inaccessible to children in care. Emergency exits are clearly marked and visible. Evacuation routes are posted and accessible for review. LPA advised that electrical outlets shall be covered or blocked by furniture to be inaccessible to children in care.

LPA observed age-appropriate toys and learning materials to be present in Room 110. Room 106 is currently in the process of being cleaned and furnished. Furniture was observed to be age-appropriate and free of rough or sharp edges. Per D1, the facility provides cots for children to nap on. Children bring their own blankets and bedding from home. Children bring lunch and snacks from home. The facility provides lunch and snacks for children as well. Water bottles are brought from home and refilled at the facility.

LPA observed the outdoor play area to contain a play structure intended for use by children ages 2 to 5. The outdoor play area is free of debris and other loose articles. There is resilient padding in the form of mats. There are age-appropriate toys and equipment available for children to use. The outdoor area is enclosed by a fence that is at least four feet high to ensure that children do not co-mingle with the elementary school during outdoor play. There are no swimming pools or other similar bodies of water present in the facility.
Continued on Page Two
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/14/2024
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 9
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-JOHN MUIR ECIA (EES) PRESCHOOL
FACILITY NUMBER: 380505931
VISIT DATE: 08/14/2024
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 Two
LPA reviewed staff records and facility records. Children’s records were not reviewed today due to children not being present. LPA observed staff files to contain immunization records and health screening reports. LPA advised that current records of Pediatric First Aid/CPR and Mandated Reporter Training shall be maintained and available for review on site. D1 stated that they understood. All SFUSD employees have been granted clearance and completed background checks as part of their hiring process. LPA observed all required postings to be posted and accessible for review outside Rooms 106 and 110. LPA advised that an updated Emergency Disaster Plan should be posted. D1 stated that they understood. D1 stated that emergency drills are conducted monthly. A drill has not been conducted yet due to summer break. The facility had conducted lead testing before the deadline of 1/1/2023 and is in compliance with lead testing requirements.

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. 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 21-21.1-CCP).


Continued on Page Three
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC809 (FAS) - (06/04)
Page: 2 of 9
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-JOHN MUIR ECIA (EES) PRESCHOOL
FACILITY NUMBER: 380505931
VISIT DATE: 08/14/2024
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 Three
LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) 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/.

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.

See LIC9102-TV and LIC9102-TA for technical violations and assistance given today. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Principal, Don Frazier.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 08/14/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/14/2024
LIC809 (FAS) - (06/04)
Page: 3 of 9