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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384000832
Report Date: 04/18/2024
Date Signed: 04/18/2024 12:18:55 PM

Document Has Been Signed on 04/18/2024 12:18 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:WIND IN THE WILLOWSFACILITY NUMBER:
384000832
ADMINISTRATOR/
DIRECTOR:		YUE, LOANNEFACILITY TYPE:
850
ADDRESS:713 MONTEREY BLVD.TELEPHONE:
(415) 333-7166
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94127
CAPACITY: 22TOTAL ENROLLED CHILDREN: 24CENSUS: 19DATE:
04/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Director, Loanne YueTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
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On 4/18/2024, at approximately 8:30AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Director, Loanne Yue (D1). Present during the visit was D1, two staff members, and 19 preschool age children. The facility is in compliance with staffing and ratio requirements on this day. The facility is a half-day program and operates from 8:30AM to 2:30PM.

LPA inspected the facility for any health or safety hazards. LPA observed there to be two fully charged 3A40BC fire extinguishers, one in the upper level and one in the lower level of the facility. There are first aid kits present in the Bathroom, Kitchenette, and the Office. LPA observed two operational carbon monoxide detectors to be present. There is a fire alarm present in addition to a smoke detector. Emergency exit signs are visible and posted at each exit. Electrical outlets are covered or obstructed by furniture to be inaccessible to children in care. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care.

LPA observed the facility to be in clean and orderly condition. There are age-appropriate toys and learning materials in the facility. Furniture is age-appropriate and free of rough or sharp edges. Per D1, children do not nap at the facility. There are labeled cubbies for each child at the facility. Children bring lunch and snacks from home. LPA observed two hand washing sinks and two toilets to be functional.

LPA observed the outdoor play area to be free of debris and other loose articles. The facility has an outdoor waiver that allows for 14 children to be present in the outdoor play area at a time. The outdoor play area is enclosed by a fence that is at least four feet high. There is a sandbox with a cover present. There are age-appropriate toys and equipment for children in care. There is a play structure with a slide. There is resilient padding in the form of mats.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/18/2024
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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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: WIND IN THE WILLOWS
FACILITY NUMBER: 384000832
VISIT DATE: 04/18/2024
NARRATIVE
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LPA reviewed personnel records, children’s records, and facility records. All staff present are qualified teachers. All teachers have current First Aid/CPR training and Mandated Reporter Training. LPA observed children’s records to be complete. Sign in and out is done using the Brightwheel app. All required postings were posted and accessible for review. LPA advised that an updated Emergency Disaster Plan (LIC610) should be posted. LPA advised that PUB269 be posted with the phone number of the health department visible. The facility last conducted an emergency drill on 3/15/2024. Emergency drills are properly logged and documented. Based on record review of the facility’s lead testing results, LPA found that the facility initially tested its fixtures for lead on 2/25/2023, past the deadline of 1/1/2023 per Written Directives specified in PIN 21-21_1-CCP. LPA discussed lead testing requirements with D1.

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).

LPA referred the facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
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: WIND IN THE WILLOWS
FACILITY NUMBER: 384000832
VISIT DATE: 04/18/2024
NARRATIVE
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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 LIC809-D for deficiency cited and cleared today regarding lead water testing. Appeal rights were provided to D1.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Loanne Yue.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 04/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/18/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 04/18/2024 12:18 PM - It Cannot Be Edited


Created By: Jonathan Tse On 04/18/2024 at 11:24 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: WIND IN THE WILLOWS
FACILITY NUMBER: 384000832

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(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.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above by testing its drinking water for lead on 2/25/2023, past the deadline of 1/1/2023, which posed a potential health, safety or personal rights risk to persons in care.
POC Due Date: 05/17/2024
Plan of Correction
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The facility tested for lead and did not have any exceedances. This deficiency shall be cited and cleared on the same day of the visit, 4/18/2024.
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.
SUPERVISOR'S NAME:Ali Zebila
LICENSING EVALUATOR NAME:Jonathan Tse
LICENSING EVALUATOR SIGNATURE:
DATE: 04/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/18/2024


LIC809 (FAS) - (06/04)
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