414001561-3-9-2023-05-CC-LGOZ-CPRRRV-20230309121546

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001561
Report Date: 03/09/2023
Date Signed: 03/09/2023 12:19:16 PM

Document Has Been Signed on 03/09/2023 12:19 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:	HIGHLANDS RECREATION DISTRICT		FACILITY NUMBER:	414001561
ADMINISTRATOR:	LEIN, KRISTEN		FACILITY TYPE:	850
ADDRESS:	1851 LEXINGTON AVENUE		TELEPHONE:	(650) 341-4251
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY:	38	CENSUS: 33	DATE:	03/09/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Kristen Lein, Colleen Han		TIME COMPLETED:	12:20 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 3/9/2023 at 08:35AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Teacher Colleen Han. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. Director, Kristin Lein arrived during inspection. Facility is licensed to operate preschool-age program. Present was the directors, seven staff supervising 33 children. Program utilizes two classrooms: Tigers, Chameleons, and one Outdoor Play Yard. Days and hours of operation are: Monday- Friday, 7:30AM.,- 6:00PM, and operated year-round. Facility was inspected indoors and outdoors for health and safety hazards.

At 8:50AM., LPA observed the following: Classrooms were clean, orderly, with age-appropriate materials available to the children. Floors and ground surfaces were free of any obstructions or potential hazards. Labeled baskets are available for storage of child’s belongings. Accessible art supplies, materials and furniture inspected were free of sharp corners or splinters. Classrooms were equipped with child- sized tables and chairs. Children’s bathroom was maintained clean with supplies or hand washing. Fixtures tested were in operating condition. Staff bathroom is located separate. For napping services, labeled mats are stored in each classroom. Per director, supplies are washed weekly by parents. Classrooms had acceptable ventilation and lighting. The disinfectants, cleaning solutions, poisons and other hazardous items have been stored inaccessible to children. Facility has built-in smoke/ carbon monoxide combination detector, on-site telephone service, and fully charged fire extinguishers: 2A:10BC. First aid kit was reviewed and is fully stocked.

At 9:20AM. LPA inspected on-site kitchen/ food preparation area. Food items inspected were current and properly stored. Kitchen had sufficient equipment for food storage and preparation. Area was free of any liter or rubbish.

At 9:30AM., LPA inspected the shared outdoor play yard. Outdoor play yard is enclosed, and free hazardous plants. Playthings, tricycles, and blocks inspected were proper repair. Play structure is properly anchored, with tanbark throughout for added safety. Per director, for water services, refillable bottles are provided for children outside. Accessible shading rest area is available.

(REFER TO 809-C FOR CONT.)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HIGHLANDS RECREATION DISTRICT	FACILITY NUMBER: 414001561
	VISIT DATE: 03/09/2023

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)
At 9:45AM LPA reviewed facility records including five children’s files and seven personnel files. Staff files contained the: Notice of Employee Rights (LIC9052); Education Verification; and Personnel Record (LIC501).

LPA reminded director to ensure staff's proof of immunization, and the required ‘Mandated Reporter Training’ certifications, AB1207 are stored in facility files. Advisory Note: Technical Assistance (LIC9102TA) was issued.

Children’s files contained the: Consent for Emergency Medical Treatment (LIC627); Updated Immunization Record, Identification and Emergency Information (LIC700); Personal Rights (LIC613A); and Notification of Parent’s Rights (LIC995).

Staff member had their current ‘Cardiopulmonary Resuscitation and First Aid’ certification, which expires on: 11/2/2024.

Emergency disaster drills are conducted every six months with the last drill completed on, 11/9/2022 properly logged.

In hallway, LPA observed required posting including: Facility License; Notice of Parent’s Rights (PUB394); Emergency Disaster Plan (LIC610); Updated Snack Menu; and Seat Belt Safety Laws.

LPA reviewed children’s medication during inspection. IMS plans were observed in the children’s files.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

(REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HIGHLANDS RECREATION DISTRICT	FACILITY NUMBER: 414001561
	VISIT DATE: 03/09/2023

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)
Based on today's inspection, no deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations. Exit interview and Report was reviewed with Director Kristin Lein, and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Facility was advised any additional questions to call office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2023

LIC809 (FAS) - (06/04)

Page: 5 of 5