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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002547
Report Date: 06/14/2023
Date Signed: 06/14/2023 10:41:16 AM

Document Has Been Signed on 06/14/2023 10:41 AM - 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:COLLUM, CHRISTINA C.FACILITY NUMBER:
414002547
ADMINISTRATOR:COLLUM, CHRISTINA C.FACILITY TYPE:
810
ADDRESS:TELEPHONE:
(415) 203-8356
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY: 14TOTAL ENROLLED CHILDREN: 11CENSUS: 11DATE:
06/14/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:02 AM
MET WITH:Christina CollumTIME COMPLETED:
11:00 AM
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On June 14, 2023, Licensing Program Analyst (LPA) Maria Olguin-Leon met with Licensee, Christina Collum, for an unannounced annual inspection. The purpose of the inspection was explained. Present today was Licensee, two adult sons, helper and 11 children (3 infant and 8 preschool). Licensee is operating within capacity and ratio requirements on this day. Licensee and helper have criminal record clearances on file with the department. Hours of operation are Monday– Friday, 7:30am to 6:00pm.

LPA and Licensee toured the home for health and safety hazards. The home is a two--story home. Day Care Areas: family room, kitchen, bathroom and backyard. Living room was approved on 03/06/2017 for napping purposes only. Off Limits Areas: Dining room, garage and entire 2nd floor. Fireplace in living room is properly barricaded with a TV. Staircase is barricaded with a child proof gate. The home is well light 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, learning material, play pens and sleeping cots. Backyard has plenty of age-appropriate play toys and small play structure. Backyard is equipped with foam mats for cushion falls and off limits are fenced off. There were no pools or bodies of water. Backyard is completely fenced off with a 4 ft. fence.

The home is equipped with a working carbon monoxide detector, smoke detector and a fully charged fire extinguisher located near entrance of home. Isolation area for ill children is in the kitchen away from other children. First aid kit is fully stocked with supplies. LPA observed IMS medication to be stored properly with required documents and physician prescription. Home is equipped with a cell phone and licensee is aware phone is to remain on premise during daycare hours. Per licensee there are no weapons or firearms in the home. Licensee provides sheets for sleeping cots and playpens and are washed weekly or when soiled.

Cont. page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/14/2023
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: COLLUM, CHRISTINA C.
FACILITY NUMBER: 414002547
VISIT DATE: 06/14/2023
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LPA reviewed 5 children’s records and all required documents were in children’s files and included LIC 282 & LIC9150. Staff was missing Mandated Reporter training; technical violation was issued. Licensee’s CPR/First Aid is current and will expire on 05/2025. Licensee provides breakfast, lunch and one snack to children in care. Children’s roster was reviewed and is up to date. Last emergency drill was conducted on 04/11/2023 and is properly documented.

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. LPA reminded licensee about Mandated Reporter training available www.mandatedreporterca.com. Licensee was reminded Mandated Reporter training must be completed by all staff who directly work with children must complete training.

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

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
LIC809 (FAS) - (06/04)
Page: 2 of 6
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: COLLUM, CHRISTINA C.
FACILITY NUMBER: 414002547
VISIT DATE: 06/14/2023
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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.

Safe Sleep


LPA discussed the safe sleep regulations with licensee Christina Collum and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resources. LPA discussed keeping sleep logs for children under 2 yrs. old.,sleep sacks and safe sleep plan.

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.

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.

Exit interview conducted and report was reviewed with the licensee, Christina Collum.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:

DATE: 06/14/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/14/2023
LIC809 (FAS) - (06/04)
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