410500083-12-12-2023-05-CC-LGOZ-CYFS4P-20231212123300

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410500083
Report Date: 12/12/2023
Date Signed: 12/12/2023 12:33:07 PM

Document Has Been Signed on 12/12/2023 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:	BUNKER HILL PARENTS PARTICIPATION NURSERY SCHOOL		FACILITY NUMBER:	410500083
ADMINISTRATOR:	TEELE, TIFFANY M.		FACILITY TYPE:	850
ADDRESS:	2145 BUNKER HILL DR, RM. 3-6		TELEPHONE:	(650) 349-1581
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY: 24	TOTAL ENROLLED CHILDREN: 24	CENSUS: 8	DATE:	12/12/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Kaitlyn Teele, Tiffany Teele		TIME COMPLETED:	12:40 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 12/12/2023 at 8:35AM., Licensing Program Analyst (LPA), Luis Gomez met with Teacher, Kaitlyn Teele. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. This facility is a parent -cooperative preschool program. Director, Tiffany Teele arrived during inspection. Present was the Director, 2 staff and 8 parents supervising 8 children. Staff members present have criminal record clearances on file. The program utilizes three rooms: Art Room, Block Room, and Discovery Room; and the Outdoor Play Area. Days and hours of operation are Monday- Friday 9:00AM- 3:30PM. Per director, program has two, morning and afternoon, cohort groups. Per director, the afternoon cohort operates on Fridays only. LPA inspected facility both inside and outside, for health and safety hazards. At 8:45AM., the following was observed: Classrooms inspected were maintained clean, orderly, and with age-appropriate materials available. The ground surfaces were clear of obstructions. Classrooms had labeled cubbies for storage of belongings. Accessible furniture, books, art supplies, and puzzles inspected were in good repair. LPA observed child- sized tables available for activities. Children’s bathroom was clean with fixtures in operating condition. Diaper changing table was available. Per director, changing table is disinfected after each use. Per director, staff/ adult bathroom is located separately. The facility was a comfortable temperature, with adequate ventilation and lighting. Unused outlets and trash bins had coverings installed. Facility had several smoke detectors, testable carbon monoxide detectors, functioning telephone service, and a fire extinguishers: 2A:10:BC. First aid kit reviewed during inspection was fully stocked. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BUNKER HILL PARENTS PARTICIPATION NURSERY SCHOOL	FACILITY NUMBER: 410500083
	VISIT DATE: 12/12/2023

NARRATIVE

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At 9:20AM., LPA inspected the outdoor play area. Area was completely enclosed, with a shade resting areas available. Climbing structures had been properly anchored. Absorbent material (tanbark) had been installed underneath structure for added safety. Accessible sandboxes was clear of debris or hazardous items. Per director, water services are provided with disposable cups.

LPA reviewed the food preparation/storage area. The food items had been properly stored, and area did not have trash or rubbish.

At 11:00AM., LPA reviewed facility records including: 5 children’s files and 6 personnel files. Staff’s files were reviewed and contained the: Notice of Employee Rights (LIC9052); Proof of required Immunization; ‘Mandated Reporter Training Certificates (AB1207); Teachers Qualifications; and Personnel Record (LIC501).

Children’s files were reviewed and contained the: Consent for Emergency Medical Treatment (LIC627); Immunization Records, Identification and Emergency Information (LIC700); Notification of Parent’s Rights (LIC995); and ‘Written Medical Assessments’.

Staff’s updated CPR/ 1^st aid certification was on file and expiring on: 9/2025.

Emergency disaster drill are conducted monthly, with last drill completed on 11/16/2023, properly logged.

Required posted had been posted in lobby including the: Facility License; Emergency Disaster Plan (LIC610); Notification of Parent’s Rights (PUB394); and Child Passenger Safety Laws (PUB269).

LPA advised the director to post snack menu for families, at least one week in advance. Advisory Note: Technical Violation (LIC9102TV) was issued to facility. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: BUNKER HILL PARENTS PARTICIPATION NURSERY SCHOOL	FACILITY NUMBER: 410500083
	VISIT DATE: 12/12/2023

NARRATIVE

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For IMS information see PIN 22-02CCP. When any IMS is provided, an updated 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 are available at: https://www.ada.gov/resources/child-care-centers/.

Assembly Bill (AB) 2370, chapter 676, statues 2018 requires all licensed child care centers (CCC’s) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and every five years after the date of the first test.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21- CCP.

Director 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.

Based on today's inspection, no deficiencies were cited in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations. Exit interview and report was discussed with Director, Tiffany Teele. Signature of this form acknowledges receipt of these documents.

This report must be made available in the facility for public review. Notice of site visit was given and must remain posted for 30 days. Director was advised if she had additional questions to contact the Community Care Licensing office, Mon-Fri, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/12/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2023

LIC809 (FAS) - (06/04)

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