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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002538
Report Date: 05/22/2023
Date Signed: 06/08/2023 02:53:23 PM

Document Has Been Signed on 06/08/2023 02:53 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:KERSEG, SARAH E.FACILITY NUMBER:
414002538
ADMINISTRATOR:KERSEG, SARAH E.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 341-9716
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
05/22/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Sarah KersegTIME COMPLETED:
01:15 PM
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On May 22, 2023. Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Sarah Kerseg, for an unannounced annual inspection. The purpose of the inspection was explained. Present today is Licensee and 6 preschool children. Licensee is operating within capacity and ratio requirements on this day. Hours of operation are Monday– Friday, 8:30am to 3:30pm.

LPA and Licensee toured the home for health and safety hazards. The home is a two-story level home. Day Care Areas: Lower level which is completely used for daycare, main classroom, dress up room and bathroom. Off Limits Areas: Entire second floor is off limits. Parents enter facility through the side gate into daycare area. Steps leading up to 2nd floor is barricaded with child proof gate and a closed door. The home is clean and has proper ventilation. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. There are plenty of age-appropriate toys, child size furnishings, and learning material all in good repair. There is loft and cubbies for the children. Fireplace is completely barricaded with storage shelving. Outdoor play area has plenty of play toys, riding toys. Backyard is completely fenced with a wood fence. There is a concrete wall separated the daycare outdoor play area and swimming pool yard. Concrete fence has a locked gate that can only be opened with a number keypad.

The home is equipped with a dual smoke/carbon monoxide detector and a fully charged fire extinguisher. Isolation area for ill children is in dress up room away from other children. First aid kit is fully stocked with supplies. Home is equipped with a landline and Licensee has a cell phone. Per licensee there are no weapons or firearms in the home.

LPA reviewed 5 children’s records and all required documents were in children’s files. Licensee CPR/First Aid is current and will expire on 02/2024. Mandated Reporting will expire 05/2024. Children’s roster was reviewed and is up to date. Last emergency drill was documented on 3/24/2023. Licensee has liability insurance through DCI Insurance.

Cont. page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 05/22/2023
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: KERSEG, SARAH E.
FACILITY NUMBER: 414002538
VISIT DATE: 05/22/2023
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Licensee was reminded that all adults 18 and over living or working in the home, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a licensed Family Child Care Home. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. Where any IMS is provided a Plan for Providing 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)/ (800)514-0383(TTY) and link to publication: Commonly Asked Questions and Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Licensee was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must 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 will 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 tools, please send them by email 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/process.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
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: KERSEG, SARAH E.
FACILITY NUMBER: 414002538
VISIT DATE: 05/22/2023
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LPA encouraged the Licensee to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. The Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.



As of today, no deficiencies were issued under CCR, Title 22, Division 12.

Exit interview conducted and report was reviewed with the Licensee, Sarah Kerseg.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 05/22/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/22/2023
LIC809 (FAS) - (06/04)
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