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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004009
Report Date: 08/16/2023
Date Signed: 08/16/2023 02:42:24 PM

Document Has Been Signed on 08/16/2023 02:42 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:MEANINGFUL BEGINNINGS LLCFACILITY NUMBER:
384004009
ADMINISTRATOR:OZUNA, YARENAFACILITY TYPE:
830
ADDRESS:633 TARAVAL STREETTELEPHONE:
(415) 941-7965
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 49TOTAL ENROLLED CHILDREN: 49CENSUS: 26DATE:
08/16/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
01:45 PM
MET WITH:Yarena OzunaTIME COMPLETED:
02:55 PM
NARRATIVE
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 Licensing Program Analyst (LPA) Van conducted an unannounced case management inspection for the Action Level Exceedance (ALE) of Lead in the Child Care Center's water in conjunction with case management in response to an unusual incident report received by the Department on August 1, 2023. A separate case management report is created for the unusual incident. LPA met with site Director Yarena Ozuna. The purpose of the inspection is explained to the Director. Today, the Center has nine teachers supervising 26 children. Among the 26 children, 11 are infants and 15 are toddlers.
LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.
LPA received an email from the site Director on 7/25/2023 informing the Licensing office of the water lead testing result. The facility received the ALE report from the Vendor on 3/3/23. Test results for this facility exceeded a higher level of parts per billion (ppb) allowed 5.5 ppb. The site Director also informed LPA that the vendor the Center used to conduct the lead testing was not an accredited company approved by the Department. As a result, the Center did not have copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), and Facility Sketch (LIC999) available.
During the inspection, LPA advised the Director to put up signs indicating that the kitchen fixture is not for drinking and/or is currently out of order. In addition, contact a certified water sampler and retest. The Site Director stated she had contacted an accredited water sampler and had scheduled a test for Tuesday, 8/22/2023. LPA advised the director to keep the department updated on the status of the fixtures. Per the Director, the facility currently has water delivered from Ready Fresh every two weeks to the Center for water ingestion and food preparation.
See next page for deficiency cited today. An exit interview was conducted and Plans of Corrections (POC) were developed and reviewed with the Site Director. A copy of this report and appeal rights were discussed and left with the Site Director, whose signature on this form confirms receipt of these reports. Notice to be remain posted for 30 days. For updates on Licensing information, go to CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 08/16/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 08/16/2023
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 08/16/2023 02:42 PM - It Cannot Be Edited


Created By: Brendon Van On 08/16/2023 at 02:08 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: MEANINGFUL BEGINNINGS LLC
FACILITY NUMBER: 384004009

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 08/16/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
08/25/2023
Section Cited

101700.3(b)(1)

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101700.3(b)(1) California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.
This requirement was not met, as evidenced by:
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The Director will put up signs indicating that the kitchen fixture is not for drinking and/or is currently out of order and will be flushing the water fixture until they are retested with a certified water sampler by 8/25/2023. The director will provide the new test results to LPA by 8/25/2023.
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Based on results received from the water sampler, the facility exceeded 5.5 ppb of lead in their water source. This poses a potential health, safety, or personal rights risk to persons in care.
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In addition, copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), and Facility Sketch (LIC999) need to be submitted to LPA by 8/25/2023.

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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:Garfield Leung
LICENSING EVALUATOR NAME:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 08/16/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/16/2023


LIC809 (FAS) - (06/04)
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