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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000199
Report Date: 05/16/2025
Date Signed: 05/16/2025 03:24:43 PM

Document Has Been Signed on 05/16/2025 03:24 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:CHILDREN'S DAY SCHOOL, INC.FACILITY NUMBER:
384000199
ADMINISTRATOR/
DIRECTOR:		GREENE, ANTONETTE B.FACILITY TYPE:
850
ADDRESS:333 DOLORES STREETTELEPHONE:
(415) 861-5432
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 60DATE:
05/16/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Director, Antonette B. GreeneTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
NARRATIVE
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On May 16, 2025, at approximately 12:30 PM, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA met with the director, Antonette B. Greene, and head of school, Shelly Luke Wille, and explained the purpose of the visit.

Children’s Day School is a preschool age program Childcare Center. Preschool program operates in 3 classrooms, Room 111 (Starfish), Room 113B (Teddy Bears), and Room 115 (Leaping Lizard).

Hours of operation are Monday through Friday 8:00am to 6:00pm. Present during LPA's visit was the director, 60 preschool age children and 10 teachers. Program is operating within capacity limits and ratio during LPA's visit. All staff present have fingerprints and background check clearance on file.

LPA inspected facility, indoors and outdoors, for health and safety hazards. Classroom includes a variety of toys and materials that were in good condition. LPA observed classroom to have age-appropriate furniture, equipment, and materials. LPA observed cleaning materials to be stored in off limit areas, inaccessible to children in care.

Per director, children nap while they are in preschool. Children sleep in cots. Per director, cots are wiped down daily. LPA observed each child to have their own individual cot. Per director, children bring their own bedrolls. Per director, sheets and blankets are taken home weekly for wash.

Classrooms are equipped with a fully charged fire extinguisher and first aid kit. LPA observed Carbon monoxide detectors and smoke detectors in the classrooms. Carbon monoxide detectors were tested during visit and were observed to be working. LPA was unable to test smoke alarm, due to alarm being wired with the entire building. Storage for children's belongings is inside the classroom. Children's cubbies are labeled with children's individual name on it. LPA did not observe any accessible poisons or chemicals in the classrooms.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Melissa Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/16/2025
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 5
California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHILDREN'S DAY SCHOOL, INC.
FACILITY NUMBER: 384000199
VISIT DATE: 05/16/2025
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There is one bathroom inside each classroom for the children to use. Each classroom has a bathroom with 3 sinks, and 3 toilets. Bathroom for children was observed to be clean. The sinks and toilet were in working condition. Bathroom was equipped with appropriate sanitation products. LPA observed bathroom to have tight fitted lids. LPA observed no cleaning solutions, poisons, and other hazardous materials for to be stored in bathroom.

Program provides a food service of snack and lunch. Per director, they have a food provider, food is delivered by “School Foodie”, for families who wish to enroll to their food program. Per director, children are also welcome to bring lunch from home. LPA observe food to be stored and maintained in kitchenette, in the class. Per director, children eat lunch in the class.

Outdoor areas are entirely enclosed and fenced. LPA observed outdoor play areas to have roof, for shade. LPA observed a play structure to have cushion flooring. LPA observed a sandbox to be well maintained. LPA observed many toys and material to be in good conditions. Per director, children bring water bottles from home and can refill them in the classroom and outside.

Program uses an app, “School Pass” for parents to sign in and out for their sign in/sign out system. Children were properly signed in during LPAs’ visit. LPA observed licensing posters and required documents to be properly posted. Program’s last disaster drills was conducted on April 23, 2025.

LPA reviewed facility staff records which were complete. LPA reviewed children facility records which were complete and had all required documents. Children's records have emergency information on file. All staff on site have a current CPR/First Aid certification and mandated reporter certification. Staff records also include required immunizations that were made available for review.

Director was reminded all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Melissa Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CHILDREN'S DAY SCHOOL, INC.
FACILITY NUMBER: 384000199
VISIT DATE: 05/16/2025
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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.

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.

Water quality was tested on 08/08/2024 and had a lead water exceedance. Facility building was constructed after 2010, there for deficiencies issued today, will be cleared today.

LPA's discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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/.

Director 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.

Please see LIC 809-D for deficiencies cited today.

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

Licensee provided director with Appeal Rights.

Exit interview conducted and report was reviewed with the director, Antonette B. Greene
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Melissa Zaragoza
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 05/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2025
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 05/16/2025 03:24 PM - It Cannot Be Edited


Created By: Melissa Zaragoza On 05/16/2025 at 02:55 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: CHILDREN'S DAY SCHOOL, INC.
FACILITY NUMBER: 384000199

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 05/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Request Denied
Type B
Section Cited
WD
101700.3(b)(1)
California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement was not met as evidenced by:
Deficient Practice Statement
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Based on results received from the certified water samplers, the facility exceeded 5.5 ppb of lead in their water source. which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/16/2025
Plan of Correction
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The facility building was constructed after 2010, and childcare center has fixed water fixture that had the lead water exceedance. Facility has retested. Therefore, deficiencies were cleared during visit.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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.
Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:
Melissa Zaragoza
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 05/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/16/2025


LIC809 (FAS) - (06/04)
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