<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004154
Report Date: 11/14/2025
Date Signed: 11/14/2025 04:16:17 PM

Document Has Been Signed on 11/14/2025 04:16 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:SSFUSD HILLSIDE CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414004154
ADMINISTRATOR/
DIRECTOR:		HAGER SULIMANFACILITY TYPE:
850
ADDRESS:1400 HILLSIDE BOULEVARDTELEPHONE:
(650) 827-8412
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 72TOTAL ENROLLED CHILDREN: 72CENSUS: DATE:
11/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Eric ClaybonTIME VISIT/
INSPECTION COMPLETED:
04:25 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 11/14/2025, at approximately 9:30AM, Licensing Program Analyst (LPA) Alvarado conducted an unannounced annual visit at the facility. LPA Alvarado met with Child Development Program Coordinator, Eric Claybon (S1). Present during the visit was (S1), Three staff members supervising 9 preschool-age children. The facility is operating within staffing and ratio requirements on this day. Facility has fingerprint clearance that is done through the South San Francisco School District.

LPA along with (S1) at approximately 9:30am inspected the facility for any health or safety hazards. The Facility’s licensed classrooms are: Room 20, Room 24 and Room 25 for Child Care Use. Currently the Facility is using Room 20 as their main classroom and Room 24 as an additional space when children wake up from Nap time or children start to wake up to ensure that the children who are napping are given a quit space to rest, with a qualified teacher providing supervision. Facility classroom has storage for children belonging in assigned and labeled cubbies. LPA Alvarado observed water bottles that were labeled with children’s names, (S1) stated that children bring water from home and are refilled with water through the day from a pitcher that has a filter providing clean drinking water. Facility uses Learning Genie to communicate with parents and verbal communication. Facility uses physical paper for parents to sign in and out.

Continued on Page 2...
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/14/2025
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 8
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)
Page: 2 of 8
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: SSFUSD HILLSIDE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004154
VISIT DATE: 11/14/2025
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 Continued...

Facility Hours of operation are from Monday-Friday 8:00AM-4:00PM. Facility provides meal services that come from the central kitchen, which is through the school district. Facility provides breakfast, lunch and snack. Classroom has meal menus posted for parent review. Facility provides napping equipment for rest time such as sheets and cots. Families provided blankets from home that’s are sent home weekly and returned the following week.

Facility classroom were observed to be equipped with fully charged fire extinguishers. Duo Fire alarm systems and Carbon Monoxide Detectors in the classroom. Per (S1) fire alarms are connected. LPA observed a Emergency Backpacks that contain First Aid equipment’s and advised on a few items that were missing from the bag. Electrical outlets were observed to be child proof and inaccessible. Per (S1) there are no weapons or firearms in the facility. LPA observed 4 functioning toilets, 3 functioning urinals, and 5 functioning sinks. (S1) stated that the facility has cleaning services from the school district that is provided once the facility is closed.

LPA during the walkthrough observed an outdoor fertilizer that was under the sink, to open the drawer it was very difficult as it jammed when trying to open making it difficult to access. (S1) Removed it immediately and made it inaccessible. (S1) was reminded that the facility must ensure to make Poisons, cleaning detergents, and other chemicals inaccessible and out of reach to children in care.

LPA observed the outdoor play areas to be free of debris and other loose articles. Outdoor play area has sufficient shading, LPA advised that additional shading should be provided such as an umbrella Play ground also has rubber foam for safe landing zones There are age-appropriate toys and equipment present. The outdoor play area is enclosed by a fence that is at least four feet high. Facility has two gate locks and Facility ensures that the locks are locked. (S1) stated that they have a staff who does a sweep through of the yard prior to utilizing children. Facility was reminded that any off-limit areas must be approved by the department prior to usage. No Pools, hot tubs, spas, or similar bodies of water present in the facility.

Continued on Page 3...
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025
LIC809 (FAS) - (06/04)
Page: 3 of 8
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: SSFUSD HILLSIDE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004154
VISIT DATE: 11/14/2025
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 Continued...

LPA reviewed 4 staff files; there is at least one staff members present who has current Pediatric First Aid/CPR training that Expires 1/2026. Staff has qualifications and permits to support their qualifications for review. Immunization records were available for review. LPA observed that a few Staff has the completed Mandated Reporter Training, During the record review LPA did see that one file did not have the updated completed Mandated Reporter Training for review. LPA reminded (S1) that every staff member must have completed mandated reporter training. LPA reviewed 5 children files, that were observed to be complete with required forms. Facility Emergency Drills have been conducted and documented. Last emergency drill was conducted and documented on October 24th, 2025. LPA reminded (S1) that Emergency drills must be conducted and logged at least once every six months. All required postings were observed to be posted and accessible for review upon entry to the facility, LPA advised on a few that needed to be posted. Facility also has all required posting for review in each classroom.

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

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test as specified in Health and Safety Code section 1597.16.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP.). LPA verified that the lead testing was completed in accordance to the Written Directives (Interim Licensing Standards) outlined in PIN 21-21.1-CCP.

Continued on Page 4...
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025
LIC809 (FAS) - (06/04)
Page: 4 of 8
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: SSFUSD HILLSIDE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004154
VISIT DATE: 11/14/2025
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 4 Continued...

facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information (https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information)

• CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES

Facility was cited on 10/22/2024 in regards to the written directives for not testing on time. Facility then tested on 1/22/2025 with a Load Date of 1/28/2025 and No Lead Exceedances.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22- 02-CCP. When 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 about Child Care Centers and the ADA, available at: https://www.ada.gov/resources/child-care-centers/.

Facility Representative was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

See LIC 809-D for deficiencies being cited today on 11/14/2025 under the California Code of Regulations, Title 22, Division 12, Chapter 1. Regarding Staff Records.

See LIC9102-TV for Technical Violation issued today regarding Physical Plant and Staff Records

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

Exit interview conducted and report was reviewed with the Facility representative, Eric Claybon.
NAME OF LICENSING PROGRAM MANAGER: Ali Zebila
NAME OF LICENSING PROGRAM ANALYST: Diana Alvarado
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2025
LIC809 (FAS) - (06/04)
Page: 5 of 8
Document Has Been Signed on 11/14/2025 04:16 PM - It Cannot Be Edited


Created By: Diana Alvarado On 11/14/2025 at 03:08 PM
Link to Parent Document Below:
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)		CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SSFUSD HILLSIDE CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004154

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/14/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in one out of one persons, it was observed that one staff member the child development program coordinator and facilitys next designee did not have the updated complete mandated reporter training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 11/21/2025
Plan of Correction
1
2
3
4
Facility will submit via email to LPA Alvarado the updated completed mandated reporter training by 11/21/2025.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Ali Zebila
NAME OF LICENSING PROGRAM MANAGER:
Diana Alvarado
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/14/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/14/2025


LIC809 (FAS) - (06/04)
Page: 6 of 8