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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002634
Report Date: 02/27/2024
Date Signed: 02/27/2024 09:20:58 AM

Document Has Been Signed on 02/27/2024 09:20 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:SBPSD ALLEN ELEMENTARY SCHOOL & PRESCHOOLFACILITY NUMBER:
414002634
ADMINISTRATOR:MCGINN, PAUAHIFACILITY TYPE:
850
ADDRESS:500 ACACIA AVENUETELEPHONE:
(650) 624-3158
CITY:SAN BRUNOSTATE: CAZIP CODE:
94066
CAPACITY: 84TOTAL ENROLLED CHILDREN: 33CENSUS: 15DATE:
02/27/2024
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Pauahi McGinnTIME COMPLETED:
09:45 AM
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On February 27, 2024 at approximately 8:15am, Licensing Program Analysts (LPAs) Catrina Quimbo and Jamel Maiwandi, conducted an unannounced, case management inspection. LPA met with licensee, Pauahi McGinn, and explained the purpose of the inspection.

Licensee requested to add use of the play yard in outdoor area located directly outside of classrooms 5H and 6H. On July 26, 2023, LPA previously measured outdoor area and reminded licensee play yard cannot be used without prior approval from department.

Hours of operation are Monday to Friday 8:00am to 3:30pm, with a morning and afternoon, during the school district calendar. Toddler option classroom operates Monday to Friday 8:00am to 4:30pm year round.

LPAs inspected updated play yard in outdoor area. LPAs observed play yard to include multiple play structures and outdoor equipment. Play structures include resilient padding underneath with wood chips. LPAs observed play structures to be age appropriate and in good condition. There is a sign on the play yard that states children ages 2 years to 5 years old are authorized to use space. LPAs did not observe any hazardous materials or loose debris.

There is sufficient shade in outdoor area from buildings. Water is made available to children through their individual water bottles that can be refilled on site. Facility previously completed lead water testing. Per licensee, emergency backpacks with first aid equipment will be taken out to the play yard during each use. LPAs observed a fully stocked emergency backpack during visit.

LPA reminded licensee grass hill behind play yard cannot be used as part of outdoor area. LPA will approve for use of play yard in playground area #2, effective today's date.

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

Exit interview conducted and report was reviewed with the licensee, Pauahi McGinn.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 02/27/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/27/2024
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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