384004412-6-15-2023-05-CC-BVAN-CSU3KS-20230615181938

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004412
Report Date: 06/15/2023
Date Signed: 06/15/2023 06:19:47 PM

Document Has Been Signed on 06/15/2023 06:19 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:	BOLCHULUUN,BUYANKHAND		FACILITY NUMBER:	384004412
ADMINISTRATOR:			FACILITY TYPE:	810
ADDRESS:			TELEPHONE:
CITY:		STATE:	ZIP CODE:
CAPACITY: 8	TOTAL ENROLLED CHILDREN: 8	CENSUS: 4	DATE:	06/15/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	03:30 PM
MET WITH:	Batmunkh Enkhzaya		TIME COMPLETED:	06:30 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 June 15, 2023., Licensing Program Analyst (LPA) Van performed an annual mandatory inspection, which included checking the interior and exterior of the facility and discussing the required childcare paperwork with the Licensee's helper/daughter, Batmunkh Enkhzaya. The purpose of the inspection was explained, and entry to the home was granted. The Licensee had a doctor's appointment and was absent during the inspection. Today, the Licensee's helper supervised four children, all infants age. Every adult living and working in the home has a criminal record clearance. Daycare areas are on the ground floor, including the main playroom/bedroom #1, bedroom #2, bathroom #1, and ½ of the backyard. Off-limit areas are the entire second floor, consisting of the living room, dining room, bedrooms #3, #4, #5, bathroom #2, #3, garage, ½ of the backyard, and laundry room. All restricted daycare areas have been appropriately blocked off from the children. The days and hours of operations are from 8:00 AM – 5:00 PM, Monday to Friday. LPA inspected the Licensee's home for health and safety hazards. The childcare is in good condition, with appropriate temperature and ventilation. All cleaning supplies, poisons, and other chemicals were kept out of reach of children. There are a fully charged fire extinguisher, smoke and carbon monoxide detectors, and a functional phone. Fully stocked first aid supplies are available for children. According to the Licensee's helper, there are no firearms or weapons. The half-backyard is completely fenced, clean, free of hazards, and has the appropriate playthings in good working condition. No pools, spas, or bodies of water were on the premises. LPA did not observe walkers, bouncers, or similar items in the home. Licensee's daughter acknowledged that smoking is prohibited in family childcare homes. Continued on page 2...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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 06/15/2023 06:19 PM - It Cannot Be Edited

Created By: Brendon Van On 06/15/2023 at 04:05 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: BOLCHULUUN,BUYANKHAND	FACILITY NUMBER: 384004412
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 06/15/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	This requirement is not met, as evidenced by a records review. The Licensee and helper do not have the required child abuse training mandated by AB 1207. This is a potential health and safety risk.
	POC Due Date: 06/30/2023
	Plan of Correction
1 2 3 4	The facility must ensure all staff members complete the mandated reporter training every two years. The Licensee helper and the Licensee will complete the training by June 23, 2023. A return visit is necessary.

Type B

Section Cited

HSC

1597.622(a)(1)

General Provisions and Definitions

(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a family day care home if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	This requirement was not met as evidenced by: Based on the interview, and record review, the Licensee's helper did not have proof of immunization available for review during the inspection. This poses a potential safety hazard to children in care.
	POC Due Date: 06/30/2023
	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:

Garfield Leung

LICENSING EVALUATOR NAME:

Brendon Van

LICENSING EVALUATOR SIGNATURE:

DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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: BOLCHULUUN,BUYANKHAND	FACILITY NUMBER: 384004412
	VISIT DATE: 06/15/2023

NARRATIVE

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LPA reviewed and discussed the new Safe Sleep Regulation with the Licensee's helper. LPA reminded the helper that playpens and cribs should have no toys or pillows inside and no objects hanging above the cribs/playpens. All mattresses shall be designed for that cribs, and bedsheets should be tight-fitted. In addition, Licensee is required to check on the infant every 15 minutes during naptime physically, and documentation shall be maintained in the infant's file and be available to the Department for review.

The facility provides breakfast and lunch, but families typically bring their food. Per Licensee's helper, the facility conducts fire and earthquake at least once every six months, with the last drills conducted on May 10, 2023. The facility posted all the required forms, such as facility License, Notification of Parent's Rights, Earthquake Preparedness checklist, and Notification of Personal Rights.

The Licensee's daughter has current Pediatric FirstAid CPR, valid until 2/26/2025

During the inspection, the following was discussed and provided to the Licensees.
· LPA discussed the safe sleep regulations with Licensee's helper and 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 Licensee's helper 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 registering all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
· The Licensee helper was reminded that as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
· The Licensee helper was reminded about the Provider Information Notices (PINs) on the CCLD website.
Continued on page 3...

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

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: BOLCHULUUN,BUYANKHAND	FACILITY NUMBER: 384004412
	VISIT DATE: 06/15/2023

NARRATIVE

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·LPA reviewed AB 1207 with the Licensee. 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.
· LPA discussed care and supervision with the Licensee. Capacity options were reviewed, and the Licensee acknowledges that care cannot be provided over the capacity specified on the License.

The Licensee helper was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to the initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this Regulation is violated.

The incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. When any IMS is provided, a Plan for Providing 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) / (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: www.ada.gov/childqanda.htm.

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.

See LIC 809D for deficiencies cited today. The Licensee's helper, Batmunkh Enkhzaya, reviewed and signed the report. Today's report, deficiency, appeal rights, and site visit notice were provided to the helper. LPA informed the Licensee's helper that a site visit notice must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:	DATE: 06/15/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/15/2023

LIC809 (FAS) - (06/04)

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