384002434-5-1-2024-05-CC-BVAN-D4UPAV-20240501110923

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384002434
Report Date: 05/01/2024
Date Signed: 05/01/2024 11:09:47 AM

Document Has Been Signed on 05/01/2024 11:09 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:	YMCA OF SF., STONESTOWN BRANCH, LUTHERAN CHURCH		FACILITY NUMBER:	384002434
ADMINISTRATOR/ DIRECTOR:	ALVAREZ, KATIA		FACILITY TYPE:	850
ADDRESS:	1011 GARFIELD STREET		TELEPHONE:	(415) 242-7135
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 29	CENSUS: 14	DATE:	05/01/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	08:20 AM
MET WITH:	Shirley Li and Katia Alvarez		TIME VISIT/ INSPECTION COMPLETED:	11:20 AM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On May 1, 2024., Licensing Program Analysts (LPAs) Van and Leong conducted an unannounced annual inspection and met with lead teacher Shirley Li. The purpose of the inspection was explained, and the staff granted LPA entry to the facility. The Center is located at the Lutheran Church of Our Savior. Three teachers supervised 14 children. The Center operates within capacity requirements and in compliance with the child-to-staff ratio. Hours of operation are Monday to Friday from 7:30 am to 6:00 pm. During the visit, the Director, Katia Alvarez, arrived. Upon arrival at the Center, the LPAs noticed that the main courtyard was undergoing renovations. According to the lead teacher, this is from a State grant that the Center was approved for to enhance its facilities. The renovation work commenced on Saturday, April 27, 2024, and is expected to be completed within two weeks. The LPAs reminded the lead teacher to promptly inform the Licensing office whenever any renovation or construction work occurs at the Center. The lead teacher will submit a written account of the renovation work, along with the date of the project's completion and any alterations made to the courtyard. LPAs have toured and thoroughly inspected the physical plant to ensure that there are no hazards that may pose risks to the children's health and safety. The facility uses an electronic sign-in/out app called CareConnect, and sign-in/out codes are provided to the parents. The facility is well-maintained with proper temperature and ventilation, and the classrooms have age-appropriate toys and learning materials. Continued on page 2...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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 05/01/2024 11:09 AM - It Cannot Be Edited

Created By: Brendon Van On 05/01/2024 at 10:24 AM

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: YMCA OF SF., STONESTOWN BRANCH, LUTHERAN CHURCH	FACILITY NUMBER: 384002434
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/01/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

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:
	Deficient Practice Statement
1 2 3 4	Based on interviews and record reviews, it was revealed that the center did not comply with the above section. Specifically, the center failed to conduct lead testing of its water used for consumption before the January 1, 2023 deadline. Failing to complete the drinking water test for lead contamination levels could pose potential health and safety risks to the children in care.
	POC Due Date: 05/17/2024
	Plan of Correction
1 2 3 4	The Center completed its lead water testing on January 4, 2023. The lead testing results show that the water fixtures are below the 5.5 ppb threshold, clearing the deficiency.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Brendon Van

LICENSING EVALUATOR SIGNATURE:

DATE: 05/01/2024

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: YMCA OF SF., STONESTOWN BRANCH, LUTHERAN CHURCH	FACILITY NUMBER: 384002434
	VISIT DATE: 05/01/2024

NARRATIVE

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The furniture is sturdy and in good condition. Moreover, the facility has a carbon monoxide detector, a centralized smoke alarm, fully charged fire extinguishers, and working telephones for emergencies. Children have designated cubbies to store their backpacks and other belongings, and each classroom has a water fountain for the children's convenience.

All emergency supplies are stored in locked storage. First aid supplies are fully stocked and available for children's use. Cleaning solutions, poisons, and other dangerous chemicals are inaccessible to children. Sleeping cots are appropriately stored.

The Center has ample restroom facilities, including four toilets and eight sinks designed for children, while the staff has a separate bathroom. All the toilets and handwashing sinks are clean and in good working condition. LPA did not observe any standing water on the premises. Due to ongoing renovations in the main courtyard, the backyard serves as the primary outdoor activity area. It is enclosed by a sturdy fence and is well-maintained, with age-appropriate toys in good condition for children to play with.

During the inspection, LPA reviewed records of children and personnel. The records for each child were found to be complete, including their names, addresses, and authorized representative telephone numbers. Each child's file also contains information about their immunization record, medical assessment, and admission agreement. Staff members' records showed that all individuals requiring caregiver background checks had undergone criminal records and child abuse index clearances or exemptions. Several teachers possess valid CPR certificates. LPA reviewed the educational qualifications of the staff members and confirmed that everyone had completed the required ECE units and mandated reporter training.

According to the lead teacher, the Center conducts its fire and earthquake drills quarterly, with the most recent drill completed on April 24, 2024.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: YMCA OF SF., STONESTOWN BRANCH, LUTHERAN CHURCH	FACILITY NUMBER: 384002434
	VISIT DATE: 05/01/2024

NARRATIVE

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The facility posted the required forms (e.g., License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). The lead teacher stated that the center provides breakfast, lunch, and pm snacks. All storage containers for solid waste within the Center have a proper tight-fitting cover.

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.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The lead teacher was informed about Mandated Reporter training AB 1207. The Mandated Reporter AB 1207 training must be completed every two years by the Licensee and for all staff hired. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

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: YMCA OF SF., STONESTOWN BRANCH, LUTHERAN CHURCH	FACILITY NUMBER: 384002434
	VISIT DATE: 05/01/2024

NARRATIVE

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The lead teacher was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE. On January 4, 2023, the Center performed water lead testing, which did not comply with the Written Directive that mandates testing for lead in all Centers built before January 1, 2010, to complete the test before January 1, 2023. As a result, the deficiency was cited but cleared on the same day.

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).

To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

A notice of site visit and appeal rights were given to the lead teacher and Director, and it must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

An exit interview was conducted, and the report was reviewed with the lead teacher, Shirley Li, and Director, Katia Alvarez.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 05/01/2024

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/01/2024

LIC809 (FAS) - (06/04)

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