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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001561
Report Date: 12/05/2025
Date Signed: 12/05/2025 12:09:33 PM

Document Has Been Signed on 12/05/2025 12:09 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:HIGHLANDS RECREATION DISTRICTFACILITY NUMBER:
414001561
ADMINISTRATOR/
DIRECTOR:		FERNANDEZ,JULIEFACILITY TYPE:
850
ADDRESS:1851 LEXINGTON AVENUETELEPHONE:
(650) 341-4251
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 15DATE:
12/05/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:45 AM
MET WITH:Julie FernandezTIME VISIT/
INSPECTION COMPLETED:
12:20 PM
NARRATIVE
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On 12/5/2025 at 8:45AM., Licensing Program Analyst (LPA), Luis Gomez met with Director, Julie Fernandez. The purpose of today's visit was explained and was for an unannounced- annual random inspection. Present was Director, and 6 staff caring for 15 children. Facility is combination, preschool center with an infant classroom on-site. The childcare center days and hours of operation are Monday- Friday, 7:30AM- 6:00PM. The preschool program utilizes two classrooms: Tigers, 3-5 year old; Chameleons, 2-3 year-old; and the Outdoor Play Yard. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 8:55AM., LPA observed the following: classrooms were neat and orderly, with age-appropriate playthings and materials available for the children. The doorways, floors, and surfaces were clean and clear of obstructions. The classrooms inspected were equipped with several activity areas for the children. LPA observed the several tables/ chairs, scaled to the appropriate size. The facility has books, art supplies, and puzzles/ blocks, in good repair. The classrooms have labeled cubbies for storage of belongings. The children’s bathroom, shared by classrooms, was observed safe and sanitary with toilets and sinks in operating condition.

LPA observed diaper changing tables available for the staff, within arm’s reach of a sink. The trash bins used for solid waste had been covered.

For nap/ scheduled rest, classrooms have foldable mats, made from a cleanable material. The mats were labeled with each child’s name and stored inside each classroom. Per director, napping supplies are washed weekly by the families.

The facility had adequate ventilation and lighting. The facility has a functioning telephone service; smoke/ carbon monoxide detectors (Built-in); and fire extinguisher (3A40BC).

Facility kitchen was reviewed during visit. Per director, food services provided include morning and afternoon snacks. The kitchen was observed clean and free of pests or vermin. The food items were properly stored and was current. (REFER TO 809C, FOR CONT.)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/05/2025
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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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: HIGHLANDS RECREATION DISTRICT
FACILITY NUMBER: 414001561
VISIT DATE: 12/05/2025
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(PAGE 2)
At 9:25AM, LPA reviewed the shared outdoor play yard. LPA area was completely enclosed, which climbing structure available for the children. An absorbent tanbark material has been installed underneath climbing area. The space included adequate shaded rest available for the children. The sandbox inspected was free of hazardous items. Per director, drinking water is readily available (inside and outside) for personal bottles, for children to drink as they wish.

Per director, highlands recreation department has swimming pool located on the premises.

At 10:00AM., LPA reviewed the facility records including a sampling of 5 children and 6 personnel files. The personnel files were reviewed contained the: Notice of Employee Rights; (LIC9052); Proof of Teacher Qualification; Proof of completed mandated reporter training (AB1207); Health Screening (LIC503); and Acknowledgement to Report Suspected Child Abuse (LIC9108)

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

The staff’s cardiopulmonary resuscitation (CPR) / pediatric first aid certification was current, expiring on: 6/2026.


The center is conducting emergency disaster drill (Fire and Earthquake), with log showing completion on: 10/16/2025.

The required postings in facility and included the: Facility License; Notification of Parent’s Rights (PUB394); Personal Rights (LIC613A); The Passenger Safety Laws (PUB269); Food Menu (December); and Emergency Disaster Plan (LIC610). LPA reminded director to post the outdoor space waiver for rotational use. (REFER TO 809C, FOR CONT.)
NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC809 (FAS) - (06/04)
Page: 3 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: HIGHLANDS RECREATION DISTRICT
FACILITY NUMBER: 414001561
VISIT DATE: 12/05/2025
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This facility does not provide Incidental Medical Services- IMS at this time. For IMS information see PIN 22-02CCP. 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/.

The 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 Child Care Center. A civil penalty of $100.00 minimum/ day for maximum of 5 days or, if the penalty is repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

The director Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

Based on today's inspection, no deficiencies were cited in the areas evaluated according to Title 22 Division 12 Chap. 1 Ca. Code of Regulations.

An exit interview discussing the facility evaluation report was conducted with Director, Julie Fernandez and signature on this form acknowledges the receipt of these documents.

This report must be made available in facility for public review. Notice of site visit was provided and must remain posted for 30 days. Director was advised, any additional questions/ concerns to contact the San Bruno Childcare Regional Office, Mon-Fri, 8:00am-5:00pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Luis Gomez
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/05/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/05/2025
LIC809 (FAS) - (06/04)
Page: 4 of 4