<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410517502
Report Date: 10/15/2024
Date Signed: 10/15/2024 01:25:30 PM

Document Has Been Signed on 10/15/2024 01:25 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:PFS- LEO J. RYAN CDC (PS)FACILITY NUMBER:
410517502
ADMINISTRATOR/
DIRECTOR:		ZEYNEP BASAKFACILITY TYPE:
850
ADDRESS:1200 MILLER AVENUETELEPHONE:
(650) 952-6848
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 72TOTAL ENROLLED CHILDREN: 44CENSUS: 41DATE:
10/15/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Claudia Espino SanchezTIME VISIT/
INSPECTION COMPLETED:
01:30 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 October 15, 2024, at 9:20am Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced, annual inspection, in conjunction with a Case management unusual incident visit. LPA met with Club Site Manager, Claudia Espino Sanchez and explained the purpose of the inspection. Director Anna Chanpesai arrived during inspection. Present in the facility today were Club Site Manager, Director, 6 staff and 41 preschool age children. All adults working in the facility have criminal background clearances and associated to the facility. Facility is operating within capacity and in compliance with staff/child ratio. Facility operates preschool program from Monday to Friday 7:30pm to 5:30pm.

The facility self-reported an incident that occurred on August 29, 2024. The incident happened in classroom #2 and involved lack of supervision that resulted in a child being left unsupervised while transitioning from classroom to outside. Per interviews and report, T1 went outside with half the classroom and T2 stayed inside with half the classroom children. T3 came in to release T2 for break and T3 took the rest of the class outside. T2 went on break and left the classroom. C1 was left in the classroom restroom alone for approx. 25 minutes. A parent came into classroom and saw child and informed staff. During today's inspection, LPA inspected the area where the incident took place. LPA spoke with Director and involved staff about the incident. Parent of unsupervised child was notified. Per Director, immediate action was taken, and an emergency meeting was conducted, all staff were retrained on child supervision and were given a verbal warning. Due to a potential health and safety risks for lack of supervision, a Type B deficiency has been issued. Please see LIC 809D for more details.

LPA and Club Site Manager toured the facility for health and safety hazards. Facility operates three preschool classrooms on the Sunshine Garden Elementary grounds, in classroom #1, #2 and Portable #P32. Facility is clean with proper temperature and ventilation. There are plenty of age-appropriate toys, furniture, indoor dramatic play area and learning materials all in good repair.

Cont. page 2...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/15/2024
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 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: PFS- LEO J. RYAN CDC (PS)
FACILITY NUMBER: 410517502
VISIT DATE: 10/15/2024
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
26
27
28
29
30
31
32
Page 2...

Storage Cubbies are available for children to store personal items and belongings. Classroom #2 is equipped with a fish tank. All classrooms are equipped with their own restroom with working toilets and sinks. There is a separate restroom on site for staff use. All trash containers in bathroom and in classroom have tight fitted lids. All cleaning products, chemicals and toxins are stored and locked in cabinet and inaccessible to children. Facility has plenty of sleeping cots available for napping and facility provides sheets and are washed weekly. Children bring their own blankets.

Playground is located behind classroom #1 & #2 and is equipped with age-appropriate toys, a large slide/climbing play structure, ride on toys and other outdoor play equipment all in good repair. Playground areas are cushioned with artificial grass cushion falls. There is a gazebo to provide shade to children. The playground flooring is asphalt for children to ride bikes and play with other playground equipment. The entire outdoors is completely enclosed with a 5 ft. chain linked fence. There are no pools, spas, or other similar bodies of water on the premises. Per Director, there are no weapons or firearms on the premises.

Facility provides breakfast, lunch and snacks for children in care and menus are available and posted in classrooms. Meals are provided from an outside vendor, Chefables. Kitchen is located in room #1 and was observed to be clean, and food stored properly to prevent contamination. Labeled water bottles with children’s names are used indoors and outdoors. Facility refills water from sink water faucet. First aid kit is fully stocked with medical supplies. Incidental Medical Services were discussed. Sick children are isolated in classrooms and away from other children, facility request parents to pick up child within half an hour.

LPA reviewed sign in/out on tablet and online portal is used by staff to view children signed in. Parents use a PIN# to access child’s name and sign signature on tablet. LPA reminded Director to have parents sign with full signatures. Classrooms are equipped with fully charged fire extinguishers, working carbon monoxide deters and smoke detectors. Facility is equipped with a landline phone and staff use walkie talkies and cell phones to communicate.

Cont. page 3...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
Page: 2 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: PFS- LEO J. RYAN CDC (PS)
FACILITY NUMBER: 410517502
VISIT DATE: 10/15/2024
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
26
27
28
29
30
31
32
Page 3...

LPA reviewed 5 children’s records 5 staff record. All the children's and staff records were complete. 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. Last emergency drill was conducted on September 25,2024 and conduct monthly and are properly documented.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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/.

Director 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.

Cont. page 4...
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
Page: 3 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: PFS- LEO J. RYAN CDC (PS)
FACILITY NUMBER: 410517502
VISIT DATE: 10/15/2024
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
26
27
28
29
30
31
32
Page 4...

Director 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.

Director 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.

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

See page LIC809 D for deficiency cited today. Appeal Rights were provided.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Club Site Manager Claudia Espino Sanchez & Director Anna Chanpesai.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 10/15/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/15/2024
LIC809 (FAS) - (06/04)
Page: 4 of 5
Document Has Been Signed on 10/15/2024 01:25 PM - It Cannot Be Edited


Created By: Maria Olguin-Leon On 10/15/2024 at 12:32 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PFS- LEO J. RYAN CDC (PS)
FACILITY NUMBER: 410517502

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/15/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101229(a)(1)
101229 Responsibility for Providing Care and Supervision: (a) "The licensee shall provide care and supervision as necessary to meet the children's needs. (1) No child(ren) shall be left without the supervision of a teacher at any time... Supervision shall include visual observation."

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the facility did not comply with the section cited above as facility self reported that there was a child left alone in bathroom during transition to outdoor play yard, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/15/2024
Plan of Correction
1
2
3
4
Facility submitted emergency meeting agenda conducted on 09/09/2024, along with signatures of staff in attendance and acknowledgement of poliicies and procedures for Supervision and transitions.

Director will continue to check in on staff during transitions to ensure the policies are being followed.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME:Marie Rodriguez
LICENSING EVALUATOR NAME:Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:
DATE: 10/15/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/15/2024


LIC809 (FAS) - (06/04)
Page: 5 of 5