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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002202
Report Date: 11/26/2024
Date Signed: 11/27/2024 08:34:55 AM

Document Has Been Signed on 11/27/2024 08:34 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:FACESSF - HAYES VALLEY CDC (INFANT)FACILITY NUMBER:
384002202
ADMINISTRATOR/
DIRECTOR:		KIMBERLY WONGFACILITY TYPE:
830
ADDRESS:305 BUCHANAN STREETTELEPHONE:
(415) 552-1535
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94102
CAPACITY: 18TOTAL ENROLLED CHILDREN: 17CENSUS: 10DATE:
11/26/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:59 AM
MET WITH:Stephanie KuyperTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On November 26, 2024, at approximately 8:45 a.m., Licensing Program Analyst (LPA) Zeynep Basak conducted an unannounced annual inspection, met with Lead Teacher Maria Martin, and explained the purpose of the visit. The director, Stephanie Kuyper, arrived around 10:00 a.m.

Upon entry, LPA observed 4 staff members, and 10 children (2 infants, and 8 toddlers) were present during today's inspection.
The facility operates the infant program with toddler component from Monday to Friday 7:30 a.m. to 5:30 p.m. The facility meets the teacher-child ratio.

LPA verified the staff members' criminal records during the inspection with the Guardian website.

Per the director, the facility uses an electronic sign-in and out app called "Learning Genie". LPA reviewed the app and found all parents' signatures matched and accounted for the number of children present today.

LPA toured the 2 classrooms, children's bathroom, and the outdoor play area to check potential health and safety hazards. LPA observed the infant and toddler room were in good shape, and the temperature and ventilation levels were proper, at room temperature. The classrooms are furnished with age-appropriate toys and educational materials. The furniture looks sturdy and well-maintained.
LPA observed 6 cribs in designated napping area in infant room and cots in the toddler room. All cribs were free from any item inside or hanging over. LPA reviewed the sleep logs for infants under 12 months.
See page 2.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE: DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/26/2024
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 4
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: FACESSF - HAYES VALLEY CDC (INFANT)
FACILITY NUMBER: 384002202
VISIT DATE: 11/26/2024
NARRATIVE
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Page 2.
During the inspection, LPA observed that each infant had an individual and labeled bottle for milk and formula and they were properly stored.

LPA observed changing tables in the infant room and the director confirmed teachers are following the disinfecting/sanitizing rules after each child. LPA observed 2 toilets, 2 sinks, and a changing table in the children's bathroom. LPA observed the bathroom was sanitary, clean, and in working condition, and the water temperature was proper.

LPA observed toys and play structures in the outdoor play area and found them in good condition, and free of health, safety, and tripping hazards.
Per the director, no pools, spas, hot tubs, fishponds, or similar bodies of water are present at the center.
LPA observed disinfectants, cleaning solutions, and other chemicals are inaccessible to children.
Per the director, there is no child has an allergy now and no medications are administered.

LPA observed the facility has a designated area at the corner of the toddler classroom for sick children while waiting for a parent/legal guardian to pick them up.

LPA observed the facility has a fully stocked first aid kit available in the classroom. LPA observed a smoke and carbon monoxide detector in each classroom and 2 fully charged fire extinguishers in size 2A10BC by the entrance and the kitchen. According to the director, the facility conducts an emergency drill once a month and the last drill was conducted on October 11, 2024.

The director stated the facility provides breakfast, lunch, and afternoon snacks in addition to milk and drinking water. Per the director, food was prepared and brought from their other site.

See page 3.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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: FACESSF - HAYES VALLEY CDC (INFANT)
FACILITY NUMBER: 384002202
VISIT DATE: 11/26/2024
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During the inspection, LPA observed all required postings are posted and visible to the public. LPA reviewed records of children and personnel. LPA found 2 infants missing LIC 9227 in the file. LPA discussed it with the director and the director printed the form to give parents to fill out today.
The rest of the required documents were in the file, including emergency cards and immunization records.
LPA reviewed the 4 staff files and found all required documents complete, including valid mandated reporter training.
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/.

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 discussed the safe sleep regulations with the director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.
See page 4.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4
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: FACESSF - HAYES VALLEY CDC (INFANT)
FACILITY NUMBER: 384002202
VISIT DATE: 11/26/2024
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Page 4
The 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.

A notice of site visit was given to the director and explained it must remain posted for 30 days.

An exit interview was conducted, and the report was reviewed with the director, Stephanie Kuyper.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Zeynep Basak
LICENSING EVALUATOR SIGNATURE:

DATE: 11/26/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/26/2024
LIC809 (FAS) - (06/04)
Page: 3 of 4