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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002235
Report Date: 11/20/2024
Date Signed: 11/20/2024 10:13:02 AM

Document Has Been Signed on 11/20/2024 10:13 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:HOLY NAME PRESCHOOLFACILITY NUMBER:
384002235
ADMINISTRATOR/
DIRECTOR:
ALICE HO SEHER, DIR.FACILITY TYPE:
850
ADDRESS:1560 40TH AVENUETELEPHONE:
(415) 664-4753
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94122
CAPACITY: 75TOTAL ENROLLED CHILDREN: 75CENSUS: 58DATE:
11/20/2024
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Alice Ho SeherTIME VISIT/
INSPECTION COMPLETED:
10:20 AM
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On November 20, 2024 at approximately 8:40am, Licensing Program Analyst (LPA) Ly conducted an Unannounced Case Management Visit and met with Site Director, Alice Ho Seher during the visit. Purpose of the inspection was explained. There were 58 children 10 staff members including the Director present during the visit.

During today’s visit, LPA confirmed with Director water outlet tested for lead is used for drinking or food preparation. On this day, the Director confirmed there is only one outlet that is used for drinking or food preparation which located in one of the preschool classroom's kitchen and lead testing result for this outlet is shown on the lead testing conducted on December 21st , 2023 in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Director also stated there are five children's sinks and one adult sink in the Red Fish classroom that children and staff only use for hand washing. In addition, there's a sink in the children's restroom by the entrance of the preschool and this outlet is also only used for hand washing.

During today's visit, Director clarified and confirmed with LPA that the two outlets that had lead exceedance in the result of lead testing conducted on January 27, 2020, labeled as Site #3-Counseling Room next to 6A and Site #5-Janitor's Closet Sink next to 8B belong to the Elementary School and the preschool children do not have access to those areas.

No deficiencies were issued today under Title 22 Division 12 of the California Code of Regulations. A copy of this report and appeal rights were discussed and left with the Director whose signature on this form confirm receipt of these reports. Notice of Site Visit was posted. Notice to remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm-

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 11/20/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/20/2024
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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