384004525-4-3-2023-05-CC-LGOZ-CQJRLN-20230403130726

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004525
Report Date: 04/03/2023
Date Signed: 04/03/2023 01:07:44 PM

Document Has Been Signed on 04/03/2023 01:07 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:	SWEET PEAS TOO		FACILITY NUMBER:	384004525
ADMINISTRATOR:	DIONNE, SAMANTHA		FACILITY TYPE:	830
ADDRESS:	2730 17TH STREET		TELEPHONE:	(415) 701-0495
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 32	TOTAL ENROLLED CHILDREN: 32	CENSUS: 14	DATE:	04/03/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Samantha Dionne, Esme Goldstein		TIME COMPLETED:	01:15 PM

NARRATIVE

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On 4/3/2023 at 8:50AM., Licensing Program Analyst, Luis J. Gomez met with Staff, Esme Goldstein. Purpose of the inspection was explained and is for an Unannounced Annual/ Random inspection. This is an Infant Program/ with Toddler Option. Present were seven staff, supervising 14 children. Licensee, Samantha Dionne arrived during inspection. Program utilizes three classroom: Toddler Room; Infant Room; Entry (Lady Bug) Room; and one, shared, outdoor play space. Hours of operation are Monday- Friday 8:00am- 5:30pm. Program operates year-round. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 8:55AM., LPA observed the following: Infant/ Toddler classrooms were clean, orderly, with age-appropriate playthings available. Floor and surfaces were free of obstructions. Facility was equipped with labeled drawers for storage of children’s belongings. Furniture, books and items were in good repair, free of splinter or sharp corners. For napping services, LPA observed available infant cribs or labeled cots. Cribs were equipped with tight-fitting sheets, and correctly sized mattresses. Infant cribs inspected have visibility on all sides for constant supervision. Per director, infant napping linins and sheets are changed weekly by staff.

At 9:10AM., Based on observations, LPA confirmed loose articles inside crib during infant nap time. Advisory Note: Technical Violation (LIC9102TV) was issued.

LPA observed two diaper changing tables, located was within arm’s reach of a sink. Children bathroom was maintained clean, with fixtures in operating condition.

Food/ bottle preparation area is located separate, with refrigeration, sink, and shelves for added storage. LPA observed infant milk and bottles/ supplies correctly stored. LPA reminded licensee to discard partially consumed bottles daily. Facility has acceptable ventilation and lighting. Trash bins and outlets have been properly covered. (REFER TO 809C FOR CONT.)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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 04/03/2023 01:07 PM - It Cannot Be Edited

Created By: Luis Gomez On 04/03/2023 at 11:44 AM

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: SWEET PEAS TOO	FACILITY NUMBER: 384004525
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 04/03/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101174(d)

Disaster and Mass Casualty Plan

(d) Disaster drills shall be conducted at least every six months. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	At 10:25AM., Based on interview and record review, LPA confirmed facility is not conducted emergency disaster drills every six months. This poses a potential health and safety risk to children in care.
	POC Due Date: 04/07/2023
	Plan of Correction
1 2 3 4	Facility will conducted emergency disaster drill by the due date: 4/7/2023. Proof will be submitted to the department via email.

Type B

Section Cited

CCR

101429(a)(2)(C)

Responsibility for Providing Care and Supervision for Infants

(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	At 11:30AM., Based on record review and interview, LPA confirmed staff is not documenting infant napping conditions each 15 minutes. This poses a potential health and safety risk to children in care.
	POC Due Date: 04/10/2023
	Plan of Correction
1 2 3 4	Facility staff will begin documenting infant napping conditions every 15 minutes, for all infants in care by the due date: 4/10/2023. Proof of correction will be submitted to the department via email.

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

LICENSING EVALUATOR NAME:

Luis Gomez

LICENSING EVALUATOR SIGNATURE:

DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

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: SWEET PEAS TOO	FACILITY NUMBER: 384004525
	VISIT DATE: 04/03/2023

NARRATIVE

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(Page 2)
Staff restroom is located separate. Detergents, cleaning supplies and sharp/ hazardous objects were made inaccessible. Facility has functioning carbon monoxide, Smoke detector (Built-in), and a fully charged fire extinguisher (2A:10BC).

At 9:45AM., LPA inspected the outdoor play area. Area is completely enclosed, with turf installed for added safety. Outdoor play area was kept clean, free of debris or hazardous plants/ objects. Outdoor equipment was in good repair and properly anchored. Per Director, sandbox is inspected daily by facility staff. For water services, staff provided children fresh water with refillable water bottles. Per director, fresh water for ingestion is privately sources.

At 10:15AM., LPA reviewed four children’s files and six personnel files. Facility files contained staff’s: Notice of Employee Rights (LIC9052); Education Verification; and Personnel Record. Staff member's CPR/ 1^st Aide Certification was Current, expiring: 6/2024.

LPA reminded licensee/ director to ensure all staff have required 'Proof of Immunization' and ‘Mandated Reporter Training’ certifications (AB1207) on file. Advisory Note: Technical Violation (LIC9102TV) was issued.

At 10:25AM., Based on interview and record review, LPA confirmed facility is not conducted emergency disaster drills in last six months.

Children files were reviewed and included the: Infant Needs and Services Plan, Consent for Medical Treatment (LIC627), Identification of Emergency Information (LIC700), Individual Sleeping Plan (LIC9227), Updated Immunization Records; and Admissions Agreement.

At 11:30AM., Based on record review and interview, LPA confirmed staff is not documenting infant napping conditions each 15 minutes.

Medication was reviewed during inspection. Licensee stated, families provide meals and facility provides snack for day-care children. Food items inspected were current.

Posting were observed in the facility including the: Facility License; Emergency Disaster Plan (LIC610); Seat Beat Safety Laws; Notification of Parent’s Rights (LIC995A); and Outdoor space waiver. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

LIC809 (FAS) - (06/04)

Page: 6 of 7

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: SWEET PEAS TOO	FACILITY NUMBER: 384004525
	VISIT DATE: 04/03/2023

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(Page 3)

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

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

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Ca. Code of Regulations and cited on 809D. Exit interview, appeal rights, and report was reviewed with Licensee/ Director, Samantha Dionne, and her signature of this form acknowledges receipt of these documents.

This report and rights to comment were discussed. This report must be available in the facility for public review. Notice was given and must remain posted for 30 days. Facility was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 04/03/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/03/2023

LIC809 (FAS) - (06/04)

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