384004886-7-22-2025-05-CC-AMEN-DJTSBW-20250722134433

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384004886
Report Date: 07/22/2025
Date Signed: 07/22/2025 01:51:22 PM

Document Has Been Signed on 07/22/2025 01:51 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:	STAR BRIDGE MANDARIN INC.		FACILITY NUMBER:	384004886
ADMINISTRATOR/ DIRECTOR:	PEIFEN CYNTHIA WANG		FACILITY TYPE:	860
ADDRESS:	608 TARAVAL STREET		TELEPHONE:	(415) 966-8109
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94116
CAPACITY: 36	TOTAL ENROLLED CHILDREN: 36	CENSUS: 0	DATE:	07/22/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:30 AM
MET WITH:	Cynthia Wang		TIME VISIT/ INSPECTION COMPLETED:	01:55 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	Licensing Program Analysts (LPAs) Andrea Medlin and Harsimran Kaur met with facility representative Cynthia Wang for this prelicensing visit. Purpose of visit explained. Applicant has requested total capacity of 31 children: 18 preschool children (ages 2 years to entry to first grade) and 13 toddlers (ages 18 - 36 months). Facility inspection conducted to ensure all requirements set forth in the California Code of Regulations, Title 22 and Health and Safety Code – which govern all licensed California Child Care facilities – are in compliance. Physical plant toured including indoor and outdoor space. Days and hours of operation are Monday-Friday 8:00AM-5:30PM. Preschool component is on second floor and Toddler component is on first floor. Teachers lounge is on 3rd floor. Facility is adequately furnished with age-appropriate toys, furniture, equipment, and first aid supplies. There are fire extinguishers, smoke detectors, and a carbon monoxide (CO) detector present. There is a total of 5 sinks, 4 toilets, 30 chairs, 3 tables, 30 cubbies, 23 cots available for preschool and toddler children. A separate staff bathroom is available on 3rd floor. Isolation area for a sick child will on the first floor. All children in the isolation area will need to always be visually supervised. Fire clearance was granted by San Francisco Fire Department on June 4, 2025. Napping equipment is available; facility will use cots for the children; they will be individually labeled. Parents will provide the napping sheets and supplies and be responsible to wash at least once a week. (Continued next page 809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: STAR BRIDGE MANDARIN INC.	FACILITY NUMBER: 384004886
	VISIT DATE: 07/22/2025

NARRATIVE

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Facility will provide meals; breakfast,lunch and afternoon snacks. Drinking water is readily available for the children via water pitchers from filtered water source. LPA observed a kitchen/ food preparation area kept clean and free of litter and rubbish; Applicant was advised that measures shall be taken to keep kitchen areas free of rodents and other vermin.

A child who is between 18 months and 36 months of age may participate in the toddler program with written permission from the child's authorized representative. No child in the toddler program shall be placed in the preschool program before the age of 30 months without written permission from the child's authorized representative

Outdoor area for preschool, toddler children were free of hazards including, holes, broken glass dry grasses, and other debris that pose a fire hazard. Shade was provided by trees and building overhead. The areas around and under high climbing has turf. LPA observed playground equipment were securely anchored to the ground. The playground is enclosed by a fence at least four feet high to protect children and to keep them in the outdoor activity area. Any construction or equipment that could pose a hazard in the outdoor activity area shall be made inaccessible to children in care. LPA observed no bodies of water.

Preschool classroom measurements are:

Indoor space was measured and inspected today for health and safety hazards. Indoor space for the classroom measures 655.99 square feet. which will accommodate applicants request for 18 preschool children.

Toddler classroom measurements are:

Indoor space was measured and inspected today for health and safety hazards. Indoor space for the classroom measures 461.51 square feet. which will accommodate applicants request for 13 toddlers.

Preschool outdoor measurements are:

Outdoor total measurement are 674.16 which will not accommodate applicants request for 18 preschool children. Facility does not have separate toddler yard.

(Continued next page 809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

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: STAR BRIDGE MANDARIN INC.	FACILITY NUMBER: 384004886
	VISIT DATE: 07/22/2025

NARRATIVE

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Drinking water from a non-contaminating fixture or container shall be readily available both indoors and in the outdoor activity area. LPA advised per Health and Safety Code 1597.16(a)(1) Lead Testing and PIN-21-21-CCP Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010 to test their drinking water for lead contamination between January 1, 2020 and January 1, 2023, and then every 5 years after the date of the first test. Per Written Directive 100700(c)(1) Written Directives for Lead Testing (1) For a license issued on or after July 1, 2022, initial testing results shall be received and posted within 180 days of licensure.

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) 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, available at: http://www.ada.gov/childqanda.htm.

LPA discussed safe sleep regulations and provided the website for Child Care Licensing Safe Sleep webpage at: https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep for reference and resource. LPA advised 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.

(Continued next page 809-C)

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

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: STAR BRIDGE MANDARIN INC.	FACILITY NUMBER: 384004886
	VISIT DATE: 07/22/2025

NARRATIVE

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Applicant was informed of the MyChildCarePlan.org site, a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California. 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-care-licensing/subscribe and select the Child Care

LPA reviewed and provided the applicant “Records to Be Maintained At the Facility” (LIC 311A), regarding record requirements for children and staff and documents to be posted.

The following corrections are needed before a licensure will be considered.

1. Approval of shared playground space waiver for all components.

Final licensure approval will be determined by review by the Centralized Application Bureau (CAB) Licensing Program Manager. Applicant agrees that upon licensure of this location, her Family Child Care Home (FCCH) license (Lic 384004154) will automatically be forfeited.

This report was reviewed with facility representatives and a copy of this report must be made available for public review upon request.

NAME OF LICENSING PROGRAM MANAGER: Deborah Lowe
NAME OF LICENSING PROGRAM ANALYST: Andrea Medlin
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 07/22/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/22/2025

LIC809 (FAS) - (06/04)

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