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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384001195
Report Date: 08/09/2024
Date Signed: 08/09/2024 04:41:22 PM

Document Has Been Signed on 08/09/2024 04:41 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:1ST PLACE 2 STARTFACILITY NUMBER:
384001195
ADMINISTRATOR/
DIRECTOR:		SANDRA DAVISFACILITY TYPE:
850
ADDRESS:1252 SUNNYDALE AVETELEPHONE:
(415) 333-2659
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY: 27TOTAL ENROLLED CHILDREN: 17CENSUS: 14DATE:
08/09/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
04:21 PM
MET WITH:Sandra DavisTIME VISIT/
INSPECTION COMPLETED:
04:55 PM
NARRATIVE
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On August 09, 2024 at approximately 02:55 PM, Licensing Program Analyst (LPA) Tso conducted an unannounced, case management visit-incident. LPA met with Director, Sandra Davis, and explained the purpose of the visit. Present in the facility is director, 4 staff, and 14 children in care.

During the incident investigation, LPA found the facility’s lead test on water was done on 3/14/2023. 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). The facility conducted their water test for lead contamination on March 14, 2023, which did not complete testing prior to their deadline. Type B deficiency citation was issued. (Please refer to LIC809D). LPA verified that the lead testing result that leads in the drinking water levels were below the current California Action limit of 5.5ppb. The deficiency was cleared on today’s visit.

An exit interview was conducted with the Director, Sandra Davis, and a plan of correction was discussed. A copy of this report with the appeal rights was discussed and provided, and the signature of this form acknowledges the receipt of these documents. A notice of site visit was given to the Director and must remain posted for 30 days
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE: DATE: 08/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/09/2024
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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Document Has Been Signed on 08/09/2024 04:41 PM - It Cannot Be Edited


Created By: Man Tso On 08/09/2024 at 04:25 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: 1ST PLACE 2 START
FACILITY NUMBER: 384001195

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/09/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/23/2024
Section Cited
HSC
1597.16(a)(1)

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1597.16(a) 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:
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The Director should have water outlets tested for lead contamination by the due date: 08/23/2024. The water was tested on 3/14/2023 with the result below the ALE. The deficiency was cleared on today’s visit.
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Based upon record review, the facility did not test for lead until 3/14/2023, which poses / posed a potential health, safety, or personal rights risk to the 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:Garfield Leung
LICENSING EVALUATOR NAME:Man Tso
LICENSING EVALUATOR SIGNATURE:
DATE: 08/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/09/2024


LIC809 (FAS) - (06/04)
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