384004334-3-21-2024-05-CC-JTSE-D3KQRB-20240321122341

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004334
Report Date: 03/21/2024
Date Signed: 03/21/2024 12:23:56 PM

Document Has Been Signed on 03/21/2024 12:23 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:	PETITE EXPLORER, INC.		FACILITY NUMBER:	384004334
ADMINISTRATOR:	ANDY WONG		FACILITY TYPE:	850
ADDRESS:	823 DIVISADERO STREET		TELEPHONE:	(415) 577-9787
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94117
CAPACITY:	42	CENSUS: 20	DATE:	03/21/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Director, Victoria Lam		TIME COMPLETED:	12:40 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 3/21/2024, at approximately 9:00AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA was granted entry to the facility by Director, Victoria Lam (D1). LPA explained the purpose of the visit. Present during the visit was the D1, six staff members, and 20 preschool age children. The facility is in compliance with staffing and ratio requirements on this day. LPA inspected the facility for any health and safety hazards. LPA observed the facility to be in clean and orderly condition. The facility is currently using two classrooms, the Wonder Classroom and the Petite Classroom. Both classrooms are equipped with age-appropriate toys and learning materials. LPA observed all trash cans to be fitted with tight-fitting lids. There are fully charged fire extinguishers present in each classroom. There is a carbon monoxide detector present in the facility. There are first aid kits present in each classroom that are stored in emergency backpacks. LPA found that all first aid kits are fully equipped with all materials necessary. There are cubbies available for each child to use. The facility provides mats for children tonap on. Bedding is brought from home and taken home once a week to be cleaned. The facility provides two snacks for children in care, and children bring lunch from home. LPA observed the outdoor play are to be free of debris and other loose articles. There are age-appropriate toys and equipment present. There is shade available for children. A sandbox is present, and per D1 is checked daily for any debris or animal droppings. There is a slide in the outdoor play area that is cushioned by resilient padding in the form of sand. There are no pools or other bodies of water present in the facility. The facility has a waiver that allows for only 26 children in the outdoor play area at a time. LPA observed that the facility was in compliance with the waiver on this day. Continued on Page Two

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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: PETITE EXPLORER, INC.	FACILITY NUMBER: 384004334
	VISIT DATE: 03/21/2024

NARRATIVE

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LPA reviewed seven staff files and six children’s files. LPA observed there to be at least one teacher present with current First Aid/CPR training, expiring on 10/2024. All staff members have current Mandated Reporter Training. Staff immunization records and transcripts are available for review. All children’s files were observed to be complete. Children are signed in via the Brightwheel app. All required postings were observed to be posted and accessible for review upon entry to the facility. Menus are posted and available for review.

LPA observed that the facility had conducted lead water sampling on 7/22/2022, within the due date of the lead testing requirements. The facility received results on 8/3/2022, with no fixtures testing above 5.4ppb. Based on record review of the lead sampling database, LPA was unable to confirm that results were uploaded. LPA found that the lab that conducted the test was not ELAP certified at the time of testing. See LIC809-D for deficiency cited today.

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.

D1 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. 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).

Continued on Page Three

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

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: PETITE EXPLORER, INC.	FACILITY NUMBER: 384004334
	VISIT DATE: 03/21/2024

NARRATIVE

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LPA referred D1 to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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/.

D1 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.

See LIC809-D for deficiency cited today regarding Lead Water Testing. Appeal rights were provided and explained to D1. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Victoria Lam.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

Document Has Been Signed on 03/21/2024 12:23 PM - It Cannot Be Edited

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: PETITE EXPLORER, INC.	FACILITY NUMBER: 384004334
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/21/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

101700.2(a)

California's Minimum Reporting Limit (a) All testing of samples shall use an ELAP certified laboratory. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on record review, the licensee did not comply with the section cited above by having a non-ELAP certified lab conduct lead testing for the facility which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/22/2024
	Plan of Correction
1 2 3 4	D1 shall conduct lead testing in accordance to the Written Directives specified in PIN 21-21.1-CCP. D1 shall submit LIC9275, LIC9276, and LIC999 forms to LPA once sampling is completed. LPA advised that lead sampling results shall be posted once received by the facility. This deficiency shall be cleared once results are uploaded to the lead sampling database without any exceedances.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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	TELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Jonathan Tse	TELEPHONE: (650) 464-4927
LICENSING EVALUATOR SIGNATURE:	DATE: 03/21/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/21/2024

LIC809 (FAS) - (06/04)

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