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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004423
Report Date: 07/30/2024
Date Signed: 07/30/2024 01:59:07 PM

Document Has Been Signed on 07/30/2024 01:59 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:CCFC-GOLDEN GATE CENTERFACILITY NUMBER:
384004423
ADMINISTRATOR/
DIRECTOR:		DOROTHY LEE GRAHAM-GRANTFACILITY TYPE:
850
ADDRESS:1455 GOLDEN GATE AVENUETELEPHONE:
(415) 921-7019
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94115
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 19DATE:
07/30/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:20 AM
MET WITH:Site Supervisor, Jodie JoubertTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
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On 7/30/2024, at approximately 11:20AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Site Supervisor, Jodie Joubert (D1), and explained the purpose of the visit. Present during the visit was D1, six staff members, eight toddlers, and eleven preschool age children. The facility is in compliance with staffing and ratio requirements on this day. The facility’s operating hours are from 7:30AM to 5:30PM, Monday to Friday.

The facility is located on the premises of Missionary Temple Christian Methodist Episcopal Church. LPA and D1 inspected the facility for any health or safety hazards. The facility is equipped with a fully charged 2A10BC fire extinguisher. There is an operational carbon monoxide detector present. LPA advised that all carbon monoxide detectors should be checked and tested frequently to ensure that they are operational. There is a fire alarm system running throughout the facility. Electrical outlets are covered or obstructed by furniture when not in use to be inaccessible to children in care. Emergency exits are clearly labeled. Evacuation routes are posted and accessible for review. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care.

LPA observed the Preschool Classroom and the Toddler Classroom to be equipped with age-appropriate toys and learning materials. Furniture is age-appropriate and free of rough or sharp edges. There are cubbies available for each child in care. LPA observed a heater to be present that has been barricaded to be inaccessible to children in care. There are heating and temperature controls to ensure the comfort and safety of children. The Preschool Classroom has access to two toilets and four handwashing sinks. The Toddler Classroom has access to one toilet and two handwashing sinks. LPA observed all toilets to be operational during the visit. Per D1, bathrooms are cleaned and sanitized after use. There are diaper changing stations present that are within hands reach of a sink. Children nap on cots with bedding that is provided by the facility. Bedding and blankets are stored in labeled containers and cleaned as needed.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/30/2024
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: CCFC-GOLDEN GATE CENTER
FACILITY NUMBER: 384004423
VISIT DATE: 07/30/2024
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Per D1, the facility provides food for children in care. Food is brought in from an off-site location, and then served to children. Food allergies are posted in the Kitchen and are accessible for review by staff preparing meals for children. The facility is nut-free. Water is provided and available for children through a filter.

LPA observed the outdoor play area to be free of debris and other loose materials. There is a separate space for toddlers that is fenced off to ensure that the different age groups are kept from comingling. There is a play structure intended for use by children ages 2 to 5. There is resilient padding in the form of artificial turf. There is a sandbox present that has been covered. The outdoor play area is enclosed by a fence that is at least four feet high. There are no pools or other similar bodies of water present in the facility.

LPA reviewed five staff files, five children’s files, and facility records. LPA observed that all staff members present have current Pediatric First Aid/CPR training. LPA observed staff’s Mandated Reporter Training to be current as of July 2024. LPA advised that all staff shall update and maintain current Mandated Reporter Training. D1 stated that they understood. Staff qualifications and immunization records were available for review. LPA observed all children’s files to be complete. LPA observed all required postings to be posted and available for review immediately upon entry into the facility. The facility last conducted an emergency drill on 7/23/2024. Emergency drills are properly logged and documented. The facility uses paper sign-in/out sheets. LPA verified that all children were signed in during the visit.

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.

Facility representative 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.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
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: CCFC-GOLDEN GATE CENTER
FACILITY NUMBER: 384004423
VISIT DATE: 07/30/2024
NARRATIVE
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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).

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

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] 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.

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/.

Facility representative 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.

No deficiencies were cited during today’s visit on 7/30/2024. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative, Jodie Joubert.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 07/30/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/30/2024
LIC809 (FAS) - (06/04)
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