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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410506949
Report Date: 07/23/2025
Date Signed: 07/23/2025 12:33:37 PM

Document Has Been Signed on 07/23/2025 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:RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)FACILITY NUMBER:
410506949
ADMINISTRATOR/
DIRECTOR:		CASTILLO, IVONNEFACILITY TYPE:
850
ADDRESS:2434 MCGARVEY WAYTELEPHONE:
(650) 482-2038
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: 22DATE:
07/23/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:44 AM
MET WITH:Chi NguyenTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On July 23, 2025, at approx. 8:30am Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced, annual inspection. LPA met with Lead teacher Chi Nguyen and explained the purpose of the inspection. Present in the facility today were, Lead teacher, 5 staff and 23 preschoolers. Criminal Background clearances for staff working at the facility are completed by Redwood City School District.. Facility is operating within capacity and in compliance with staff/child ratio. The facility operates a part-time and full-time preschool program Monday -Friday. Full time program operates from 8:00am-4:00pm, year-round. Part time program runs from 9:00am-12:00 pm and afternoon program from 1:00 pm – 4:00 pm following school year calendar.

LPA toured the indoors and outdoors of the facility for health and safety hazards. Preschool program operates on the site of Roosevelt Elementary School. Preschool program operates in three classrooms #34, #35 and #36. Part time classroom operates in classroom #35, which is closed during summer. Classrooms are clean and orderly with proper temperature and ventilation. LPA observed a variety of age-appropriate toys, child size furniture, learning materials, indoor dramatic play areas and sleeping mats/cots all in good repair. Storage bins are available for children to store personal items and belongings. Each classroom has a restroom with a working toilet and sinks with no running hot water. A separate restroom is available for staff use. Trash containers in restrooms and classrooms have tight fitted lids. All cleaning products, chemicals and toxins are stored and locked in cabinets and inaccessible to children. LPA observed sleeping mats and cots labeled with children’s names. Children bring their own bedding from home and are sent home weekly for laundering.

There are two outdoor play areas. One outdoor area is between classroom #35 and #36 and is equipped with a gardening area, playhouses, ride on toys and other age-appropriate toys, in good condition. This area extends to the front of classrooms, which is an open area for children to run and play. LPA observed permanent canopies outside to provide shade for children in care. Entire outdoor play areas are enclosed with a 5 ft. fence. LPA did not observe any pools, spas, or other similar bodies of water on the premises.

Cont. Page 2...
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/23/2025
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 5
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: RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)
FACILITY NUMBER: 410506949
VISIT DATE: 07/23/2025
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The facility provides breakfast, lunch and snacks for children in care via Redwood City School District and delivered daily. LPA observed menus posted and reminded the facility to post current menus. LPA observed kitchenettes to be clean, and food stored properly to prevent contamination. Classrooms have a stove, microwave, sink and refrigerator. Children bring their own water bottles from home and are labeled with children’s names. Facility refills water bottles from classroom sinks. First aid kits are fully stocked with medical supplies. Incidental Medical Services were discussed. Sick children are isolated in an area in classroom not in use and away from other children. Per Lead teacher, there are no weapons or firearms on the premises.

Children are signed in and out on their own individual sign in/out sheet and facility maintains a dot sheet to account for children in attendance for the day. Classrooms are equipped with fully charged fire extinguishers. LPA observed each classroom equipped with a working carbon monoxide detector. Fire detectors in classrooms #34 & #36 were tested and observed to not be working, a work order request was submitted to maintenance during LPA's visit. Classrooms are equipped with landline phones and cell phones for communication with parents.

LPA reviewed 6 children’s files and 6 staff files; two staff files did not have completed LIC503 health screening, technical assistance was issued. The facility has all necessary paperwork posted, Facility License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. Technical assistance was provided for posting of current menus. Last emergency drill was conducted on May 28, 2025, and is properly documented.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. 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/.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC809 (FAS) - (06/04)
Page: 5 of 5
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: RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)
FACILITY NUMBER: 410506949
VISIT DATE: 07/23/2025
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LPA discussed the safe sleep regulations with Lead teacher 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 licensee [or facility representative] 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.

Lead teacher was reminded that all adults 18 and over, 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.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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

Lead teacher was informed of the MyChildCarePlan.org website; 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.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)
FACILITY NUMBER: 410506949
VISIT DATE: 07/23/2025
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To improve the quality and value of the new inspection process, a survey may be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or CARE tools, please send email inquiries to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process

During LPA’s visit no deficiencies were issued in accordance with Title 22 regulations.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements may result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Lead teacher, Chi Nguyen.
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 07/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/23/2025
LIC809 (FAS) - (06/04)
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