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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003012
Report Date: 11/22/2024
Date Signed: 11/22/2024 01:40:13 PM

Document Has Been Signed on 11/22/2024 01:40 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:SUNSHINE PRESCHOOL CENTERFACILITY NUMBER:
384003012
ADMINISTRATOR/
DIRECTOR:		YUZON, NADINEFACILITY TYPE:
850
ADDRESS:650 ANDOVER STREETTELEPHONE:
(650) 291-0512
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 30TOTAL ENROLLED CHILDREN: 30CENSUS: 7DATE:
11/22/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:35 AM
MET WITH:Carolyn Arrospide, Maria SanchezTIME VISIT/
INSPECTION COMPLETED:
12:35 PM
NARRATIVE
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On 11/22/2024 at 8:35AM., Licensing Program Analyst (LPA), Luis Gomez met with Lead Teacher, Carolyn Arrospide. The purpose of today's visit was explained and was for an unannounced, annual random inspection. This is a preschool school program with a toddler option. Present was Lead Teacher and 1 staff supervising 7 children. Site Supervisor, Maria Sanchez and Licensee, Nancy Azar arrived during inspection. Staff have criminal record clearances on file. Per Site Supervisor, program’s toddler option is not currently in use. Days and hours of operation are Monday- Friday, 7:15AM- 6:00PM. Preschool Program utilizes one classroom and the outdoor play space. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 8:40AM., LPA observed the following: Classroom has age-appropriate materials and playthings available for the children. Furniture, toys, and puzzles inspected were in good repair.

At 8:47AM., Based on observations, LPA confirmed hazardous floor rug, wall area, and furniture located in facility.



Classroom is equipped tables, chairs, scaled to the appropriate size. Cubbies are available in entry for storage of children’s belongings. Staircase has been made inaccessible with child safety gate. The children’s bathrooms were observed clean, with toilets and faucets in operating condition. Staff bathroom located separately. LPA observed diaper changing table available for staff use.

At 8:50AM., Based on observation, LPA confirmed drinking water is not made available for children in care.

Facility has extra cabinets available. Facility has adequate lighting; ventilation; and was a comfortable temperature for the children. Facility had a functioning telephone service and fire extinguisher. Per director, carbon monoxide/ smoke detector is built-into the building. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/22/2024
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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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: SUNSHINE PRESCHOOL CENTER
FACILITY NUMBER: 384003012
VISIT DATE: 11/22/2024
NARRATIVE
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(PAGE 2)
At 9:15AM, LPA reviewed the outdoor play area. Area was completely fenced, with playthings in proper repair. Shaded rest area is available for the children.

At 9:20AM., LPA observed rusted planter bins accessible to day-care children. Advisory Note: Technical Violation (LIC9102TV) was issued.

During inspection, LPA reviewed the facility records including a sample of the children and personnel files. The personnel files reviewed contained Teacher's Qualifications; Notice of Employee Rights (LIC9052); and Acknowledgement to Report Suspected Child Abuse (LIC9108).

At 10:25AM., Based on record review, LPA confirmed staff proof of immunization missing from facility records. Advisory Note: Technical Violation (LIC9102TV) was issued.

At 10:30AM., Based on record review, LPA confirmed staff's proof of completed mandated reporter training course (AB1207) are missing from facility files. Advisory Note: Technical Violation (LIC9102TV) was issued.

Children’s files were reviewed and contained the: Notification of Parent’s Rights (LIC995); Immunization Record; and Identification and Emergency Information (LIC700).

LPA reminded facility, children files must include required forms including the: LIC627, LIC995A, and Medical Assessment for each child in care. Advisory Note: Technical Violation (LIC9102TV) was issued

Staff’s cardiopulmonary resuscitation / first aid certification was current, expiring 10/2025.
At 11:00AM., Based on record review, LPA confirmed emergency disaster drill has not been conducted within the last six months.

Required postings in facility and included the: Facility License; Notification of Parent’s Rights (PUB394); Personal Rights (LIC613A); Outdoor Space Waiver; and The Passenger Safety Laws Form (PUB269).

LPA reminded site supervisor to update written emergency disaster plan (LIC610) with current staff. Advisory Note: Technical Violation (LIC9102TV) was issued. (REFER TO 809C, FOR CONT.)
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
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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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SUNSHINE PRESCHOOL CENTER
FACILITY NUMBER: 384003012
VISIT DATE: 11/22/2024
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(PAGE 3)
Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02CCP. 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/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, deficiencies were observed, in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on 809D. An exit interview including plan for correction, and facility evaluation report was discussed with Director, Maria Sanchez. Staff’s signature on this form acknowledges receipt of these documents.



This report must be made available in facility for public review. Notice of site visit was provided and must remain posted for 30 days. Director was advised, any additional questions/ concerns to contact the office, M-F, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 11/22/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/22/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 11/22/2024 01:40 PM - It Cannot Be Edited


Created By: Luis Gomez On 11/22/2024 at 11:51 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: SUNSHINE PRESCHOOL CENTER
FACILITY NUMBER: 384003012

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239.2(a)
Drinking water from a noncontaminating fixture or container shall be readily available both indoors and in the outdoor activity area.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 8:50AM., Based on observation, LPA confirmed drinking water is not made available for children in care. This poses a potential health and safety risk to children in care.
POC Due Date: 12/06/2024
Plan of Correction
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Facility will ensure drinking water is available both inside and outside by the due date: 12/6/2024.
Proof of correction will be submitted the Department via email.
Type B
Section Cited
CCR
101117(d)
101117(d) Disaster and Mass Casualty Plan: Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 11:00AM., Based on record review, LPA confirmed emergency disaster drill has not been conducted within the past six months. This poses a potential health and safety risk to children in care
POC Due Date: 12/06/2024
Plan of Correction
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Facility will conduct emergency disaster drill by the due date: 12/6/2024.
Proof of correction will be submitted to the Department via email.
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:Luis Gomez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2024


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Document Has Been Signed on 11/22/2024 01:40 PM - It Cannot Be Edited


Created By: Luis Gomez On 11/22/2024 at 01:28 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: 11/22/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101238(a)
101238(a) Building and Grounds: (a) The child care center shall be clean, safe, sanitary and in good repair at all times to ensure the safety and well-being of children, employees and visitors.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 8:47AM., Based on observations, LPA confirmed hazardous floor rug, wall area, and furniture located in facility. This poses a potential health and safety risk to children in care. This poses a potential health and safety risk to children in care.
POC Due Date: 12/06/2024
Plan of Correction
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Facility will remove hazardous rug from facility by the due date: 12/6/2024.
Proof of correction will be submitted to Department via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Luis Gomez
LICENSING EVALUATOR SIGNATURE:
DATE: 11/22/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/22/2024


LIC809 (FAS) - (06/04)
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