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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004868
Report Date: 06/06/2024
Date Signed: 06/06/2024 04:43:17 PM

Document Has Been Signed on 06/06/2024 04:43 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:MISSION KIDSFACILITY NUMBER:
384004868
ADMINISTRATOR/
DIRECTOR:
CHRISTINA MALUENDAMARCHIELFACILITY TYPE:
860
ADDRESS:969 TREAT AVENUETELEPHONE:
(415) 970-9027
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 96TOTAL ENROLLED CHILDREN: 96CENSUS: 74DATE:
06/06/2024
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:45 AM
MET WITH:Heather LubeckTIME VISIT/
INSPECTION COMPLETED:
04:45 PM
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On 6/6/2024 at 11:45AM., Licensing Program Analyst (LPA) Luis Gomez met with Assistant Director, Heather Lubeck. The purpose of today’s inspection was explained was for a Pre-licensing inspection to Add a Toddler Option. Licensee has requested to add a toddler option (18 -36 months) in classrooms #1 and #2. Present during inspection was the assistant director and 29 parent/ staff supervising 74 children. Program's day and hours of operation are Monday - Thursday, 8:30AM- 4:00PM. LPA inspected facility, and measured facility's indoor and outdoor space.

Facility is licensed for a total capacity of 96 children.

Indoor: Classroom #1 was measured and had a total usable square footage of 258.731 sq ft. Total usable square feet, divided by 35 equals to 7 children. Classroom #2 was measured and had a total usable square footage of 267.110 sq. ft. Total usable square feet, divided by 35 equals to 7 children.

Classrooms have shared bathroom, equipped with 2 toilets, 2 sinks, and diaper changing table for staff. Diaper changing table was within arms reach of a sink. Per assistant director, area is disinfected after each use. Bathroom fixtures were in operating condition. LPA observed several trash bins with tight-fitting lid. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/06/2024
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 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: MISSION KIDS
FACILITY NUMBER: 384004868
VISIT DATE: 06/06/2024
NARRATIVE
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(Page 2)

The indoor space was observed clean and neat, with all furnishings, playthings, and equipment in safe condition. Floor and ground surfaces were clear of obstructions or hazards. LPA observed storage in classroom #1 for children's belongings. Furniture inspected was in like-new condition and was free of splitters or sharp corners.

For napping services, LPA observed individual sleeping bags stored in facility. Per assistant director, napping sheets are washed weekly by the families.

Classrooms were equipped with a fire extinguisher (2A:10B:C), smoke and carbon monoxide detectors (Built in), and food preparation/ storage area. Storage area in classrooms #1, #2, includes food (snack), medication, first aid kit, and emergency supplies. Classrooms had adequately ventilated, lighting and was comfortable temperature. Cleaning supplies, toxins, detergents, and other hazardous items have been stored inaccessible to children.

LPA measured the designated toddler play yard. Outdoor: Total useable square footage of outdoor play yard measures 383 sq ft. Total usable sq feet, divided by 75 sq ft, allows for a total of 5 children. LPA observed the outdoor play space is completely enclosed with absorbent rubber installed. Area had age-appropriate toys and equipment available.

Isolation of ill children will be in the office will be used for an ill child.


Per Assistant Director, daily lunches are provided families. LPA reminded licensee to ensure food brought to the facility is properly labelled.
(REFER TO 809C, FOR CONT.)
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024
LIC809 (FAS) - (06/04)
Page: 2 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: MISSION KIDS
FACILITY NUMBER: 384004868
VISIT DATE: 06/06/2024
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(Page 3)
Assistant Director understands that the age range for the toddler option is 18 months to 36 months old and that authorized representatives must give written permission for their child to participate in the toddler component. Ratio and staffing for the toddler option was discussed.

Assistant Director understands that preschool and toddler option children cannot commingle with preschool-age children at any time. Director was reminded toddler option can accommodate a maximum group size of 12 toddler per grouping. Director understands that the children must be kept physically separation from the preschool age children. Director understands that the toddler option children cannot commingle on the preschool in the outdoor space.

LPA discussed the safe sleep regulations with Assistant Director and discussed 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 applicant 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.

The fire inspection was conducted, and approval was received on 3/14/2024.

Facility provides Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. For IMS information see Title 22 Regulations 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


(REFER TO 809C, FOR CONT.)
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024
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: MISSION KIDS
FACILITY NUMBER: 384004868
VISIT DATE: 06/06/2024
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Prior to recommendation for toddler option in classrooms #1, #2 , facility will complete the following:

-Submit LIC200A


-Submit LIC309
-Submit Updated Parent Handbook
-Submit Updated Admission Agreement / Written Permission
-Submit Updated Job Description for Toddler Teachers/Staff
-Submit Director’s Proof of Qualification
-Submit Outdoor Play Schedule/ Activity Schedule
-Submit Waiver Request for Rotational Use of Toddler Play Yard.

-Installed Children Storage in Classroom #2
-Posted Required forms in Classroom #1, #2
-Submit Certificate of Final Completion

>No deficiencies were observed in areas evacuated according to the Title 22, Division 12, Chapter 1 of Ca. Code of Regulations.

The Notice of Site Visit was provided and posted during inspection.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 06/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4