384004802-5-7-2024-05-CC-CQUO-D52QXL-20240507123344

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004802
Report Date: 05/07/2024
Date Signed: 05/07/2024 12:33:54 PM

Document Has Been Signed on 05/07/2024 12:33 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:	DONUM DEI NEST PRESCHOOL		FACILITY NUMBER:	384004802
ADMINISTRATOR/ DIRECTOR:	SWANSON, SARAH		FACILITY TYPE:	850
ADDRESS:	1550 TREAT AVENUE		TELEPHONE:	(415) 874-9631
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 15	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	05/07/2024
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Sarah Swanson		TIME VISIT/ INSPECTION COMPLETED:	01:00 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 May 7, 2024 at approximately 9:00am, Licensing Program Analyst (LPA) Catrina Quimbo conducted a scheduled, pre-licensing inspection. LPA met with applicant, Sarah Swanson, and explained the purpose of the inspection. Application was received October 26, 2023. As of this date, fire clearance has not been obtained. The applicant is requesting for a preschool license for a capacity of 15 preschool children (ages 2 years to 5 years old). Program is currently in the process of obtaining a director. The facility will operate Monday through Friday 8:00am to 3:30pm with aftercare from 3:30pm to 5:30pm. The program will operate at Donum Dei Classical Academy in the "Nest" classroom only. Applicant plans for children to be signed in and out of facility with authorized representatives' written signatures. The facility was inspected indoors and outdoors, for health and safety hazards, and measured to calculate capacity. Indoors: There is one classroom for the preschool program called the "Nest" classroom. "Nest" classroom is located behind the covered, outdoor area. "Nest" classroom was measured for 565.27 sq. ft. allowing for a capacity of 16 children. LPA reminded applicant, classroom will be licensed as is. Department must be made aware of and approve of any additional constructional changes to classroom. LPA observed "Nest" classroom to be well ventilated with appropriate temperature. Classroom is equipped with furniture, toys and materials that were observed to be new, age appropriate and in good condition. Flooring in classroom was observed to be clean, with new carpets. LPA observed carpets to be secured to classroom floor. There is sufficient storage space for children's personal belongings, located inside the classroom, that are secured to the wall. Applicant plans for cubbies to be labeled with children's individual names. Garbage bins in classroom were observed to have tight fitting lids. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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: DONUM DEI NEST PRESCHOOL	FACILITY NUMBER: 384004802
	VISIT DATE: 05/07/2024

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LPA observed electrical outlets in classroom to be made inaccessible, with child safety covers. Applicant plans for poisons, cleaning supplies and hazardous materials to be stored in classroom's high cabinets. Classroom is equipped with a fully stocked first aid kit and a dual smoke/carbon monoxide detector. Applicant tested smoke/carbon monoxide detector during visit, which LPA observed to be working. Facility also includes a fire extinguisher that was observed to be fully charged.

Medications with prescription labels for children and required documentation will be maintained in classroom's high shelves, inaccessible to children. Medication that require refrigeration will be maintained in staff's kitchenette.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) tollfree 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, available at: http://www.ada.gov/childqanda.htm.

Program plans to provide napping children with mats. Children's families are to provide blankets, program will provide sheets. Per applicant, blankets will be sent home weekly or as needed. Sheets will be laundered by program weekly or as needed. There are additional blankets on site if needed.

Applicant plans for isolation area to be in elementary school's office. Emergency protocols were discussed. Applicant plans for 911 services to be contacted, if needed, and contacting the child's parents/ authorized representatives. Program's discipline policy was discussed. Applicant plans for children to be removed from situation and redirected. Applicant also plans for staff to partner with children's families for additional support.

Preschool program will have access to elementary school's girl's restroom, located directly outside preschool classroom. Applicant plans to label 2 stalls in girl's restroom to be for preschool use. There are 2 toilets and 2 sinks preschool children will have access to. Total allowable capacity for toilets is 30 children. Total allowable capacity for sinks is 30 children. LPA observed sinks and toilets to be in proper working condition. Sinks children have access to do not provide water that is warmer than 120 degrees Fahrenheit. LPA reminded applicant children must be supervised going to and from bathrooms.
(Continue Report on Page 3...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

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: DONUM DEI NEST PRESCHOOL	FACILITY NUMBER: 384004802
	VISIT DATE: 05/07/2024

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Program does not plan to provide a food service at this time. Families will be required to provide their child with morning snack, lunch, afternoon snack and individual water bottles. There are snacks available on site, if needed. LPA reminded applicant children's personal items must be labeled with children's individual names.

Outdoor: The outdoor area is located directly outside the "Nest" classroom that includes a covered turf area, play structure, and basketball court. Total outdoor area measures for 4,357.48 sq. ft. allowing for a capacity of 58 children. There is a play structure that was observed to have resilient padding underneath. Outdoor area has sufficient shade coverings. Preschool program also has access to second floor garden and soccer field. LPA reminded applicant children must always be supervised going to and from the outdoor areas. LPA observed outdoor area to be entirely enclosed and fenced. LPA did not observe any spas, bodies of water or pools on site.

LPA reviewed with applicant, the LIC 311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

LPA reminded applicant to conduct and document emergency disaster drills at least once every six months. The requirement for Lead Water Testing was discussed (H&S Code 1597.16). Applicant was reminded a facility licensed after July 1, 2022, must have their water fixtures tested for lead 180 days after licensure and every 5 years thereafter. LPA advised applicant to review PIN 21-21-CCP. Program purchases bottled water that is delivered to facility.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Applicant was informed of the MyChildCarePlan.org site, 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.
(Continue Report on Page 4...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: DONUM DEI NEST PRESCHOOL	FACILITY NUMBER: 384004802
	VISIT DATE: 05/07/2024

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/ subscribe and select the Child Care option to receive email communication.

Based on indoor square footage, maximum number program can be licensed for is 16 preschool children.

Prior to licensure, following to be completed:
-Inaccessibility to monkey bars on play structure in playground.
-Fire clearance with updated capacity.
-Director's qualifications.
-Labelling of preschool toilets in elementary school girl's restroom.
-Request for waiver of shared use of elementary school girls' restroom.

Exit interview conducted and report was reviewed with the applicant, Sarah Swanson.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 05/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/07/2024

LIC809 (FAS) - (06/04)

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