414001022-1-6-2025-05-CC-MZAA-DCNRVT-20250106122205

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001022
Report Date: 01/06/2025
Date Signed: 01/06/2025 12:22:14 PM

Document Has Been Signed on 01/06/2025 12:22 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:	BELLE AIR PRESCHOOL		FACILITY NUMBER:	414001022
ADMINISTRATOR/ DIRECTOR:	ITZA GONZALEZ		FACILITY TYPE:	850
ADDRESS:	450 3RD AVENUE		TELEPHONE:	(650) 624-3158
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY: 96	TOTAL ENROLLED CHILDREN: 96	CENSUS: 32	DATE:	01/06/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:50 AM
MET WITH:	Director, Itza Gonzalez		TIME VISIT/ INSPECTION COMPLETED:	12:35 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 January 6, 2025, at approximately 9:50 AM, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA met with the director, Itza Gonzalez, and explained the purpose of the visit. Belle Air Preschool is a preschool age program. Preschool has 3 classrooms licensed, rooms 1, 2, and 5. Program currently operates in all three classrooms. Hours of operation are Monday through Friday 8:00am to 3:00pm. Present during LPA's visit was the director, 32 preschool age children and 6 staff members. Preschool program is operating within capacity limits and ratio during LPA's visit. LPA inspected facility, indoors and outdoors, for health and safety hazards. Classrooms includes a variety of toys and materials that were in good condition. LPA observed classrooms to have age-appropriate furniture, equipment, and materials. LPA observed classrooms to have trash cans with tight fitted lids. Per director, children sleep inside the classroom, in cots. Per director, parents provide sheets and blankets. Per director, parents take sheets and blankets home for wash weekly, or when needed. LPA observed cots to be maintained for children enrolled, in a room between classroom 1 and 2. Sleeping cots were observed to have each child’s individuals name on it. Per director, cots are wiped down and sanitized daily. All classrooms are equipped with a fully charged fire extinguisher and first aid kits. LPA observed Carbon monoxide detectors in the classrooms. Carbon monoxide detectors were tested during visit and were observed to be working. LPA was unable to test smoke alarm. Smoke alarm is wired with the entire school. Storage for children's belongings is in classrooms cart. Children's cubbies are labeled with children's individual names on it outside the class. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

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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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: BELLE AIR PRESCHOOL	FACILITY NUMBER: 414001022
	VISIT DATE: 01/06/2025

NARRATIVE

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There is one girl’s bathroom and one boys bathroom outside the classrooms. Bathroom for children was observed to be clean. Bathroom for boys has 1 toilet, 1 changing table, 2 urinals, and 2 sinks. The girl’s bathroom has 3 stalls, 1 changing table, and 2 sinks. LPA observed bathroom sinks and toilets to be in working condition. LPA observed no cleaning solutions, poisons, and other hazardous materials for to be accessible to children in the bathroom.

Per director, the school district provides lunch for children, and children eat inside the cafeteria. LPA observed children’s water bottles to be stored inside a container in a cart, inside the classroom. Per director, children refill their water bottle inside the classroom, and when children go outside to play, the teacher takes the cart out.

Facility has 1 outdoor space area. Outdoor area is entirely enclosed and fenced. LPA observed outdoor play area to have installed sunshades. LPA observed play structure to have cushion flooring. Outdoor materials are stored outside, inside of a shed. LPA observed toys and material to be in good condition.

Program uses a form for parents to sign in and out for their sign in/sign out system. Children were properly signed in during LPAs’ visit. LPA observed licensing posters and required documents to be properly posted inside the classroom. Program’s last disaster drills was conducted on December 20, 2024.

LPA reviewed 7 facility staff records. LPA reviewed 6 random children facility records which were complete and had all required documents. Children's records have emergency information on file. All staff on site have a current mandated reporter certification. Staff records also include required immunizations that were made available for review.

Director was reminded all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

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

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: BELLE AIR PRESCHOOL	FACILITY NUMBER: 414001022
	VISIT DATE: 01/06/2025

NARRATIVE

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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.

Water quality was tested on 07/12/2023 and results complied. Lead water was tested after the due date of 1/1/23.

LPA's discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed director 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-care-centers/.

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.

Program was cited a Type B citation for not completing lead water testing requirement by due date of January 2023. Appeal Rights were provided. Facility's lead levels were within the 5.5ppb threshold, therefore deficiency cited today will also be cleared today.

Please see LIC 809-D for deficiencies cited today.

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

Exit interview conducted and report was reviewed with the director, Itza Gonzalez.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:	DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 01/06/2025 12:22 PM - It Cannot Be Edited

Created By: Melissa Zaragoza On 01/06/2025 at 12:08 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: BELLE AIR PRESCHOOL	FACILITY NUMBER: 414001022
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 01/06/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, the licensee did not comply with the section cited above by not completing lead testing by January 1, 2023 which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 01/06/2025
	Plan of Correction
1 2 3 4	Facility tested water fixtures on 07/12/2023, after the lead testing requirement due date. Water fixtures tested are below the 5.5 ppb threshold. Deficiency cleared during visit.

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:

Melissa Zaragoza

LICENSING EVALUATOR SIGNATURE:

DATE: 01/06/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/06/2025

LIC809 (FAS) - (06/04)

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