384004189-3-6-2024-05-CC-MTSO-D3549K-20240306175428

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004189
Report Date: 03/06/2024
Date Signed: 03/06/2024 05:54:38 PM

Document Has Been Signed on 03/06/2024 05:54 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:	APPLE TREE CHILDREN CENTER-INFANT		FACILITY NUMBER:	384004189
ADMINISTRATOR:	LIN, SHUYING		FACILITY TYPE:	830
ADDRESS:	1331 HARRISON STREET		TELEPHONE:	(415) 695-4726
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94103
CAPACITY: 16	TOTAL ENROLLED CHILDREN: 2	CENSUS: 2	DATE:	03/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	04:47 PM
MET WITH:	Shuying Lin		TIME COMPLETED:	06:10 PM

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 March 6, 2024, at approximately 2:03 pm, Licensing Program Analyst (LPA) Tso met with Director Shuying Lin for an unannounced required visit to the child care center listed above. LPA explained the reason for the inspection and was granted access to the facility. This is a combination Center with Infants, and Preschool programs operating in the same building with different licenses. The infant program has 1 teacher supervising two children today. The facility staff-to-child ratios are met. Hours of operation are Monday- Friday, 8:00 am- 5:00 pm. LPA assessed the Center for Health and Safety Hazards with the Director. Per Director, there are no changes to the existing physical plant. The facility maintains a record of sign-in/out for infants, and all parent signatures were accounted for and matched the number of infants present. The infants' classroom environment appeared clean and organized, with appropriate heating, lighting, and ventilation. The Center also provided age-appropriate toys, furnishings, changing tables, and equipment. LPA did not observe any pools, spas, or other bodies of water, nor did they notice any bouncers, exersaucers, or similar equipment at the facility. According to the Director, no firearms or weapons are present at the Center, and all cleaning materials and potentially hazardous objects are kept out of reach of children. Personnel restrooms are separate from children, and all solid waste storage containers have tightly fitted lids. The Center also maintains a carbon monoxide detector, centralized smoke alarm, fully charged fire extinguisher, and First Aid kit. Designated cubbies are available for children to store their belongings. The diaper changing table has at least 1" thick padding, is covered with disposable paper, and has at least 3" elevated edges. The changing tables are within arm's reach of the sink, and disposable wipes are used to clean after each usage. There is sufficient sleeping equipment and cots for each child, and all mats and bedding are kept in the appropriate location. Food and formula are provided by parents. The facility has an outdoor waiver approved by the Department that allows no more than 16 children at one time. (Continued on page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)

Page: 1 of 3

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: APPLE TREE CHILDREN CENTER-INFANT	FACILITY NUMBER: 384004189
	VISIT DATE: 03/06/2024

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
26
27
28
29
30
31
32

(Continued, page 2…)
LPA checked the personnel and two children's records at the facility. A sample of children's files was found to contain comprehensive information such as medical assessments, needs, services, feeding plans, and signed admission agreements. The staff files were also well-organized and thorough with Mandated Reporter Training Certificate (AB1207) valid until 1/1/26 respectively. The staff member was observed to have valid CPR/First Aid cards and vaccine proofs for Measles, Pertussis, and Influenza in their files. Additionally, the facility had posted the required documents, including the license, menus, waivers, Notification of Parental Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. The most recent emergency drill being held in January 2024.

LPA discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

LPA reminded the Director that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles.

The 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 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.
(Continued on page 3…)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: APPLE TREE CHILDREN CENTER-INFANT	FACILITY NUMBER: 384004189
	VISIT DATE: 03/06/2024

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
26
27
28
29
30
31
32

(Continued, page 3…)
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.

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). Please refer to the license number 384004188 that runs in the same building for the lead test.

The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to be completed every two years by all staff hired a one-time General Training is also required. 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

The Director 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.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

No deficiencies were cited today under CCR, Title 22, Div. 12, Chapter 3. A copy of today’s report was given to the Director.

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

Exit interview conducted and report was reviewed with the Director, Shuying Lin.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Man Tso
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

LIC809 (FAS) - (06/04)

Page: 3 of 3