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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002312
Report Date: 03/21/2024
Date Signed: 03/21/2024 02:40:51 PM

Document Has Been Signed on 03/21/2024 02:40 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:KANGAROOS PRESCHOOL IIFACILITY NUMBER:
384002312
ADMINISTRATOR:FLORES, ANGELINAFACILITY TYPE:
850
ADDRESS:298 MONTEREY BLVD.TELEPHONE:
(415) 333-4452
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94131
CAPACITY: 39TOTAL ENROLLED CHILDREN: 39CENSUS: 39DATE:
03/21/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:37 PM
MET WITH:Christina Medina, Angelina Flores and Natella ShternTIME COMPLETED:
03:07 PM
NARRATIVE
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On March 21, 2024 at approximately 1:37pm, Licensing Program Analyst (LPA) Catrina Quimbo, conducted an unannounced, case management visit in regards to lead testing requirements. LPA met with assistant director, Christina Medina, director, Angelina Flores, and licensee, Natella Shtern and explained the purpose of the visit.

Present during visit included 39 preschool children with 7 staff. Kangaroos Preschool operates in a multi-level building that includes 4 classrooms.

Program provides a food service that includes snacks only. Children's families provide children with lunch daily. Snack is prepared in facility kitchen, located on second floor of building. Children have access to drinking water through their individual water bottles that can be refilled on site through filtered water pitchers. Per director, filtered water pitchers are refilled through sink in Koalas classroom and sink in kitchen.

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.

Water fixtures used for food preparation and drinking purposes were tested for lead levels February 2024. Water fixtures tested are below the 5.5 ppb threshold. During visit, LPA was provided copies of lead testing report, LIC9275, and LIC9276.

LPA referred director to the Department website for lead: Toxicity Prevention and Water Testing Information.

Facility is being cited a Type B citation for not completing lead water testing that is within accordance to Written Directives by due date. Appeal Rights were provided during visit. Deficiency will be cleared during today's visit as testing was completed.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with licensee, Natella Shtern.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 03/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/21/2024
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 03/21/2024 02:40 PM - It Cannot Be Edited


Created By: Catrina Quimbo On 03/21/2024 at 01:30 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: KANGAROOS PRESCHOOL II
FACILITY NUMBER: 384002312

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/21/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
03/21/2024
Section Cited
HSC
1597.16(a)(1)

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HSC 1597.16(a)(1) A licensed child day care center... 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...

This requirement is not met as evidenced by:
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Facility tested water fixtures used for food preparation and drinking in March 2023. Water fixtures tested are below the 5.5 ppb threshold.
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Based on interview and record review, the licensee did not comply with the section cited above by not completing lead testing by January 1, 2023 in accordance to written directives, which poses a potential health, safety or personal rights risk to persons in care.
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Deficiency cleared during visit.

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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:Marie Rodriguez
LICENSING EVALUATOR NAME:Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:
DATE: 03/21/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/21/2024


LIC809 (FAS) - (06/04)
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