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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004534
Report Date: 01/26/2023
Date Signed: 01/26/2023 03:37:41 PM

Document Has Been Signed on 01/26/2023 03:37 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SUNSHINE ADVENTURES NOB HILLFACILITY NUMBER:
384004534
ADMINISTRATOR:MIDLYN CHENFACILITY TYPE:
850
ADDRESS:1439 PACIFIC AVETELEPHONE:
(415) 699-5820
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94109
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 14DATE:
01/26/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
01:24 PM
MET WITH:Midlyn ChenTIME COMPLETED:
03:50 PM
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On January 26, 2023 at approximately 1:20 PM, Licensing Program Analyst (LPA) Nathan Garcia met with Director, Midlyn Chen for an unannounced annual inspection. Purpose of the inspection was explained. Upon arrival, the director was not present and the director had to be contacted by staff. Per phone conversation with director, she just stepped out for lunch and will be back in 30 minutes to the facility with the files. Present, in the facility are Director, and 5 teachers, including floaters, supervising 14 children during nap time. There are 2 teachers present in each of the 2 classrooms. Facility is operating within its capacity and is in compliance with staff/child ratio on this day. Facility operates day care from Monday - Friday 8:00am to 5:30pm.

With Director, LPA inspected 2 total day care rooms and the outdoor space. LPA observed facility has combined smoke detectors and carbon monoxide detectors, 2 fully charged fire extinguisher model 3A40BC located on multiple areas. The facility has a working telephone on site. All cleaning solutions, poisons, and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age-appropriate furniture. Facility floor and rugs are in good repair and free of any hazards.

There are first aid supplies available in the classrooms and in the office. All bathrooms are in working condition. All food is stored properly to avoid contamination. Facility has enough sleeping cots/mats available and provides sheet/blankets from home. Brought every Monday and on Fridays to be washed. Individual items provided by the parents are labeled and stored appropriately. One AM and PM snacks and lunches are brought from home. Per director, the children are provided through kitchen sink that recently passed the lead water testing, as main source of drinking water. All foods must be nut-free whenever a child with nut allergy is present, and food preparation area is free of litter. Food is stored adequately to prevent contamination and properly labeled. Facility uses outdoor waiver to utilize the park nearby. There is water available for children in the yard as well as in the classrooms and emergency bags. There was a small outdoor and there were no hazards and small play structures are stable and age appropriate with a slide. The outdoor toys are kept in a bin/chest when not in use. The outdoor area has push toys and a table.

LPA reviewed the Water Lead samples from the certified water samplers, and observed that one fixture tested has passed. Director forwarded Licensing forms and results to LPA email.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/26/2023
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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SUNSHINE ADVENTURES NOB HILL
FACILITY NUMBER: 384004534
VISIT DATE: 01/26/2023
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According to the director, the facility in transitioning to using CareConnect Application for sign in/out sheet. Some of the parents are using a mixture of the application and the physical paper signing sheet from Wu Yee. All authorized representatives have signed. Facility has license and all other required documents posted and visible for the public. Facility has an emergency drill log and last drill was conducted on December 22, 2022. Per Director, drills are done every 6 months.

The LPA reviewed the facility records. LPA reviewed 3 random children's files. All required files were available in folders. LPA reviewed 5 staff files with qualifying requirements such as ECE Units, CPR and Mandated Reporter Training. The facility has a set learning curriculum that includes story time, and movement posted in each classroom.



The 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 a Child Care Center.

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.

Facility was informed 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 or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file.

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: SUNSHINE ADVENTURES NOB HILL
FACILITY NUMBER: 384004534
VISIT DATE: 01/26/2023
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This facility provides Incidental Medical Services – IMS. According to the director, there are no children with with allergies. These are stored properly in the office cabinets. LPA reviewed storage of ointments for rashes only. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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: http://www.ada.gov/childqanda.htm

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3. This report must be available in the facility for public review.

Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

Report was reviewed and signed by director, Midlyn Chen.

Today’s report, and notice of site visit will be printed and given to the director.
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE:

DATE: 01/26/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/26/2023
LIC809 (FAS) - (06/04)
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