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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001019
Report Date: 03/26/2024
Date Signed: 03/26/2024 04:16:32 PM

Document Has Been Signed on 03/26/2024 04:16 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-RICHMONDFACILITY NUMBER:
384001019
ADMINISTRATOR:ELLEN PETERSON-ALLENFACILITY TYPE:
850
ADDRESS:426 33RD AVENUE, 2ND FLOORTELEPHONE:
(415) 386-3096
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94121
CAPACITY: 30TOTAL ENROLLED CHILDREN: 29CENSUS: 18DATE:
03/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Kelly LITIME COMPLETED:
04:40 PM
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Licensing Program Analyst (LPA) Mok conducted an unannounced annual inspection today. LPA met with the Site Director, Kelly Li, and an administrative, Sasha Camel, and explained the purpose of the inspection to her. There were 18 children with 8 staff and a Site Director present. The children were napping during the inspection. All adults have fingerprint clearance. The facility is located on the upper level of the Pine Methodist Church. There is another daycare facility located on the lower level in the same building. The facility's operation hours are Monday to Friday from 8 AM to 5:30 PM. LPA inspected the facility for health and safety hazards. There were 3 classrooms such as Classroom 1 (FD 1), 2 (FD 2), and a multipurpose classroom (Big Room) next to the office. The facility was clean and in order, the temperature and lighting were adequate, and toxins and harmful objects were made inaccessible to the children. There were plenty of age-appropriate toys, books, learning equipment and children's furniture available in each classroom. The children's furniture was in good repair and condition. There was a sink in classroom #1 & #2 available for the children. There was a children's bathroom on site with a total of 2 toilets, and 2 sinks were available for children. All toilets and sinks were reachable by children. All hot water in all the children's sinks was shot off, only cold water. Cubbies were available for children's use. Separated staff bathrooms were available for staff on the same floor. The facility barricaded the wall heater and made it inaccessible to the children in each room. The isolation area for ill children was the director's office. The facility had an outdoor play area that was shared with another facility (ABC Preschool) on the lower level with an outdoor space waiver for no more than 20 children at a time; The Facility also used the public park nearby for outdoor play every day if weather permits. Cots were available for napping, Parents have taken the blankets home to wash every Friday. The facility has provided breakfast, lunch, and snacks for children via Chefable. The food preparation areas were clean and in order. The food waste bins had tight lids in the facility. Drinking water was served in a water pitcher with cups for children indoors and outdoors; staff brought water bottles with cups for outdoors. The facility has posted the required forms (ie License, menus, Weekly Activities schedule, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). Fire and Earthquake drills were done monthly and properly logged. The facility has used an electronic Sign in/out system. The system was called." Jupiter". At least one staff had current CPR & First Aid training at the center. Also, most of the staff had the current Mandated Reporter Training certificate for review. LPA also reviewed the children's & Staff files and obtained a copy of the current children's roster during the inspection. There were a couple of children on special medication. LPA inspected the storage of the medication and documents along with it during the inspection,
continues in LIC 809C
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE: DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/26/2024
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-RICHMOND
FACILITY NUMBER: 384001019
VISIT DATE: 03/26/2024
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Criminal Record Clearance - Licensee was reminded that all adults 18 and over living or working in home, 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 licensed Family Child Care Home. 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.

Safe Sleep - LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. When any IMS is provided, a Plan for Providing 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)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KAI MING HEAD START-RICHMOND
FACILITY NUMBER: 384001019
VISIT DATE: 03/26/2024
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MyChildCarePlan.org – Licensee 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.


Notice of Site Visit - A notice of site visit was given and must remain posted for 30 days.

Exit Interview - Exit interview conducted and report was reviewed with the licensee, .
Kelly Li,
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Cindy Mok
LICENSING EVALUATOR SIGNATURE:

DATE: 03/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/26/2024
LIC809 (FAS) - (06/04)
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