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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000350
Report Date: 06/04/2024
Date Signed: 06/04/2024 12:01:43 PM

Document Has Been Signed on 06/04/2024 12:01 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:GAZELLE DEVELOPMENTAL SCHOOLFACILITY NUMBER:
414000350
ADMINISTRATOR/
DIRECTOR:
MASON, GLORIAFACILITY TYPE:
850
ADDRESS:770 N. EL CAMINO REALTELEPHONE:
(650) 347-8411
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 34TOTAL ENROLLED CHILDREN: 26CENSUS: 20DATE:
06/04/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:06 AM
MET WITH:JonPaul BarkhurstTIME VISIT/
INSPECTION COMPLETED:
12:15 PM
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On 6/4/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Child Care Center (CCC) listed above. LPA met with the Assistant Director, JonPaul Barkhurst, and explained the purpose of the visit. Twenty preschool-aged children and three staff members were present during the visit. The three staff members present at the CCC received criminal record clearance from the department. The CCC operates within its capacity and in accordance with the required ratio of staff to children.

LPA observed that all required documents were displayed, such as the facility license, waivers, parental and personal rights notifications, car seat laws, emergency disaster plan, and daily activities schedule.

The last emergency disaster drill was conducted on 1/24/2024 and properly recorded.

According to the Assistant Director, the CCC provides snacks for the children and children are required to bring their own lunch. LPA emphasized the importance of sanitation and proper food preparation. Snacks were observed to be available during the visit.

LPA observed that the CCC currently documents the child's attendance by manually recording it on paper.

Prescribed medications were observed to be properly stored in a cabinet and labeled according to the child's name.

LPA conducted an inspection for potential health and safety hazards and found the interior of the CCC to be clean, safe, and well-maintained. The CCC was observed to have a first aid kit, functioning smoke and carbon monoxide detectors, and a fully charged fire extinguisher.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GAZELLE DEVELOPMENTAL SCHOOL
FACILITY NUMBER: 414000350
VISIT DATE: 06/04/2024
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The classrooms were equipped with age-appropriate toys, furniture, and educational materials, and each child had their own designated storage space.

The bathrooms were found to be clean and fully functional. The toilets and handwashing facilities were kept safe and sanitary.

All accessible cabinets and drawers in the classrooms were found to be free of hazardous materials or poisons. Hazardous items were stored in the kitchen and were inaccessible to the children.

The outdoor playground was enclosed by a fence, and the equipment was well-maintained. No bodies of water, such as pools or spas, were present in the outdoor area.

The sleeping/resting area, including mats, was observed to be clean and sanitary

LPA reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information.

LPA reviewed the files for three staff members and confirmed that all two were up to date with their Pediatric First Aid/CPR certifications. LPA also found that all three staff members had completed the necessary twelve units in Early Childhood Education, meeting the qualifications to be classified as a teacher.

LPA reminded the Assistant Director that Mandated Reporter Training must be completed every two years.

Facility Representative 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.

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SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: GAZELLE DEVELOPMENTAL SCHOOL
FACILITY NUMBER: 414000350
VISIT DATE: 06/04/2024
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LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed 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.

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-carecenters/.

Facility Representative 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

LPA collected the lead water report and other supporting documents from the Assistant Director. The report indicated that the lead water testing was conducted on 3/4/2023. LPA reminded the Assistant Director to contact the lead water testing vendor and ensure that the results are uploaded to the California Waterboards database.

No deficiencies were issued today during LPA's visit.

A copy of today’s report was given to the Assistant Director, JonPaul Barkhurst. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Assistant Director, JonPaul Barkhurst.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 06/04/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2024
LIC809 (FAS) - (06/04)
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