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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004001
Report Date: 11/04/2025
Date Signed: 11/04/2025 12:36:57 PM

Document Has Been Signed on 11/04/2025 12:36 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:KAI MING EARLY HEAD START-BROADWAY CENTER INFFACILITY NUMBER:
384004001
ADMINISTRATOR/
DIRECTOR:		CARMEN NGANFACILITY TYPE:
830
ADDRESS:820 BATTERY STREETTELEPHONE:
(415) 982-4570
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94111
CAPACITY: 25TOTAL ENROLLED CHILDREN: 25CENSUS: 21DATE:
11/04/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:42 AM
MET WITH:Jun Tao HuTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On November 4, 2025, Licensing Program Analyst (LPA) Van conducted an annual random inspection and met with the Family Service Specialist (FSS) JunTao Hu. The inspection purpose was explained, and the FSS granted LPA entry to the facility. According to the FSS, the center Director, Carmen Ngan, is currently on vacation. This is a combination center with preschool and infant & toddler programs. At the time of inspection, the infants and toddlers program had 8 teachers supervising 21 children; among them, 8 were infants and 13 were toddlers. The facility complies with the staff-children ratio today.

The days and operations hours are Monday - Friday from 8:00 a.m. to 4:00 p.m.

All staff members present during the inspection had their criminal record clearances verified through the CDSS Guardian Background Check site and were found to have an eligible clearance status.

Along with the FSS and the classroom lead teachers, LPA toured and inspected the physical plant to identify potential health and safety hazards. The facility is well-maintained and has proper heating, lighting, and ventilation. The center is currently utilizing an electronic sign-in and sign-out application called Jupiter. Upon reviewing the records, it has been confirmed that each parent was assigned a unique code. The parents' legal names and signatures were recorded during sign-in and sign-out.

Both infant and toddler classrooms are well-stocked with appropriate age toys and educational materials. The furniture is sturdy and well-maintained. The facility has carbon monoxide, centralized smoke detectors, multiple fully charged fire extinguishers, and functioning telephones. All cleaning products and disinfectants are kept out of the reach of children.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/04/2025
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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California Health & Human Services Agency
California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:
  • Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.
  • Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)
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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: KAI MING EARLY HEAD START-BROADWAY CENTER INF
FACILITY NUMBER: 384004001
VISIT DATE: 11/04/2025
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LPA observed that each child has an individual cubby. All emergency equipment is secure. The center provides Incidental Medical Services. Upon reviewing children's medications, it was found that they were stored securely, inaccessible to children, in their original containers, unaltered, with parental consent.

A separate bathroom is available for staff use on the premises. According to the FSS, no pools, spas, or bodies of water are on the premises. Furthermore, the FSS stated that the center has no guns or weapons on site.

There is a designated area where infants can rest or nap without being distracted or disturbed. The area is equipped with sufficient sleeping equipment and cots for each child, and all mats and bedding are stored in their appropriate location. LPA reminded the FSS that emergency exits must always remain clear and that cots and cribs cannot be placed in a way that obstructs them.

During the inspection of the designated nap area, it was observed that one of the cribs against the wall had an air purifier plugged into an outlet, with the wire protruding and visible through the crib's gap, making it accessible to children. During the visit, the staff relocated the cribs and placed a cabinet to block the outlet.

Per the FSS, the center provides disposable diapers and wipes for the infants. The facility has a designated changing table, equipped with at least 1" thick padding and covered with disposable paper. The changing tables have at least 3" elevated edges to prevent accidents. The changing table was observed to be located within arm's reach of the sink, and disposable wipes were used to clean the area after each use. The FSS has been reminded that the diaper changing area and sink must be reserved for their intended use only, not for food preparation or as a counter to store classroom activities or teacher resources.

According to the FSS, the center provides bottles, nipples, and other food-service items for its infants. The FSS stated that the center currently has no infants who bring breast milk from home. All infants at the center use baby formulas, which are prepared in the kitchen. The kitchen site is kept clean, organized, and inaccessible to children.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
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: KAI MING EARLY HEAD START-BROADWAY CENTER INF
FACILITY NUMBER: 384004001
VISIT DATE: 11/04/2025
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The outdoor play area is kept clean and free of debris, fully fenced, and in good condition. The outdoor play structures are rated for children aged 2-12 years. However, according to the FSS, infants and toddlers do not use this play structure; instead, the center has a movable partition that blocks the play structure's area. Furthermore, the FSS stated that the infants' and toddlers' groups have their own outdoor schedules, which differ from the preschool program.

During the visit, LPA requests a rotation schedule for the infant/toddler and preschool. A revised outdoor rotation schedule waiver will be created and sent to the center.

LPA reviewed the personnel and children's records at the facility. A sample of children's files contained complete information, including medical assessments, needs, services, feeding plans, and signed admission agreements. The staff members' files have proof of educational credentials. Multiple staff members were observed to have valid CPR cards and proof of vaccination for Measles, Pertussis, and Influenza in their files. All staff members have up-to-date mandated reporter training certificates.

The facility posted the required documents, including the license, menus, waivers, notifications of parental rights and personal rights, the car seat law, and the emergency disaster plan.

The FSS stated that fire and earthquake drills are conducted monthly, with the most recent drills completed on 10/16/2025.

The FSS 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.

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.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC809 (FAS) - (06/04)
Page: 4 of 6
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: KAI MING EARLY HEAD START-BROADWAY CENTER INF
FACILITY NUMBER: 384004001
VISIT DATE: 11/04/2025
NARRATIVE
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CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:

LPA verified that the lead testing was completed in accordance with the Written Directives outlined in PIN 21-21.1-CCP.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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/.

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

LPA discussed Child Abuse Mandated Training AB1207 with the FSS. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the FSS. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The FSS was advised that a free one-hour online course is available on the Department of Pesticide Regulation's website: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

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.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC809 (FAS) - (06/04)
Page: 5 of 6
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: KAI MING EARLY HEAD START-BROADWAY CENTER INF
FACILITY NUMBER: 384004001
VISIT DATE: 11/04/2025
NARRATIVE
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During today’s inspection, LPA requested the following update documents from the Center.
· LIC 308 – Designation of Responsibility
· LIC 500 – Personnel Report
· Outdoor rotation schedule for the infant/toddler and preschool program, along with an official written outdoor rotation schedule waiver request.

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

Exit interview conducted, and the report was reviewed with the Family Service Specialist (FSS), JunTao Hu.Edna Vargas, Regional Manager.
NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/04/2025
LIC809 (FAS) - (06/04)
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