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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003012
Report Date: 07/06/2023
Date Signed: 07/06/2023 04:15:10 PM

Document Has Been Signed on 07/06/2023 04:15 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SUNSHINE PRESCHOOL CENTERFACILITY NUMBER:
384003012
ADMINISTRATOR:YUZON, NADINEFACILITY TYPE:
850
ADDRESS:650 ANDOVER STREETTELEPHONE:
(650) 291-0512
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 2DATE:
07/06/2023
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME BEGAN:
04:00 PM
MET WITH:Nancy Azar, Silvia VelasquezTIME COMPLETED:
04:20 PM
NARRATIVE
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On 7/6/2023, at 2:15PM Licensing Program Analyst (LPA) Luis J. Gomez met with Lead Teacher, Silvia Velasquez to conducted an unannounced; plan of correction inspection. Purpose of inspection was explained. This Case Management report is to cite for deficiency observed during inspection. Licensee, Nancy Azar arrived during inspection. LPA inspected facility for health and safety hazards.

At 2:20PM., Based on observations, interview and record review, LPA confirmed one staff, S1, providing care for both the toddler/ preschool programs.



Based on today’s inspection, deficiencies were observed in areas evacuated according to the Title 22 Division 12 of Ca. Code of Regulations and cited on the 809D. An exit interview, report and plan of correction was discussed with the Licensee, Nancy Azar and signature of this form acknowledges the receipt of these documents.

A copy of this report and appeal rights were reviewed and provided to the licensee. Notice of site visit was posted and shall remain posted for 30 days.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 07/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/06/2023
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 07/06/2023 04:15 PM - It Cannot Be Edited


Created By: Luis Gomez On 07/06/2023 at 03:37 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: SUNSHINE PRESCHOOL CENTER
FACILITY NUMBER: 384003012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 07/06/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
07/10/2023
Section Cited
HSC
1596.956(a)(4)

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1596.956(a)(4) Child day care centers serving infants; optional toddler program; departmental guidelines and regulations: A ratio of six children to each teacher shall be maintained for all children in attendance at the toddler program. An aide who is participating in on-the-job training may be substituted for a teacher when directly supervised by a fully qualified teacher. This requirement was not met as evidenced by:
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Licensee will ensure the toddler, and preschool classrooms each have fully qualified teacher present at all times.

Licensee will submit updated staff schedule (LIC500) by due date: 7/10/2023.
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At 2:20PM., Based on observations, interview and record review, LPA confirmed one staff, S1, providing care for both the toddler/ preschool programs. This poses a potential health and safety risk to children in care.
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Proof of correction will be submitted to the department via email.

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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:Ali Zebila
LICENSING EVALUATOR NAME:Luis Gomez
LICENSING EVALUATOR SIGNATURE:
DATE: 07/06/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 07/06/2023


LIC809 (FAS) - (06/04)
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