414004280-2-17-2023-05-CC-LGOZ-CP62EA-20230217161937

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004280
Report Date: 02/17/2023
Date Signed: 02/17/2023 04:19:52 PM

Document Has Been Signed on 02/17/2023 04:19 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:	MUSHRAN, VRINDA		FACILITY NUMBER:	414004280
ADMINISTRATOR:	MUSHRAN, VRINDA		FACILITY TYPE:	810
ADDRESS:			TELEPHONE:	(650) 740-7761
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94065
CAPACITY: 14	TOTAL ENROLLED CHILDREN: 14	CENSUS: 9	DATE:	02/17/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:50 PM
MET WITH:	Vrinda Mushran		TIME COMPLETED:	04:35 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 2/17/2023 at 1:50PM., Licensing Program Analysts (LPA), Luis J. Gomez met with Licensee, Vrinda Mushran. Purpose of the inspection was explained and was for an Unannounced; Annual Random inspection. Present in facility was the licensee and assistant caring for 9 children. All children are present are preschool age. Adults have criminal record clearances on file. Licensee home is 4 bedroom, 3 bathroom, and 2 level house. Days and Hours of operation are: Mon- Fri: 8:00am- 5:00pm. Day-care areas: Lower Level: Family room (Playroom); Living Room (Napping Only); Bathroom #1; Laundry Room; Kitchen; and Side Yard Off-limits areas: Lower Level: Garage (Pass through only), Backyard and Entire Upstairs Level. LPA inspected home with licensee for health and safety hazards. At 2:00PM., the following was observed: Facility was clean, orderly with age-appropriate playthings available for the children. Floors and ground surfaces were clear of obstructions or hazards. Accessible furniture, blocks and children’s books inspected were in good repair. LPA reminded licensee to ensure fireplace is barricaded. Playroom has child sized table and chairs for meals and seated activities. For napping services, LPA observed several napping mats stored in closet. Bathroom #1 is equipped with adequate supplies for hand-washing. Fixtures tested were in operating condition. Safety locks have been installed on cabinets in kitchen. Off-limit areas and staircase have been made inaccessible with safety gates. Facility was the proper temperature, with ventilation and lighting. Home had functioning telephone; smoke detector; carbon monoxide detector; and fire extinguisher, 2A:10BC. (REFER TO 809C, FOR CONT)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

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 5

Document Has Been Signed on 02/17/2023 04:19 PM - It Cannot Be Edited

Created By: Luis Gomez On 02/17/2023 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: MUSHRAN, VRINDA	FACILITY NUMBER: 414004280
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/17/2023

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	At 2:35PM., Based on record review and interviews, LPA confirmed licensee's 'Mandated Reporter Training' (AB1207) certification has expired. This poses potential health and safety risk to children in care.
	POC Due Date: 02/27/2023
	Plan of Correction
1 2 3 4	Licensee will renew Mandated Reporter Training Certification, (AB1207) by the due date: 2/27/2023. Proof of correction will be submitted to department via email.

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.

SUPERVISOR'S NAME:

Ali Zebila

LICENSING EVALUATOR NAME:

Luis Gomez

LICENSING EVALUATOR SIGNATURE:

DATE: 02/17/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

LIC809 (FAS) - (06/04)

Page: 2 of 5

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: MUSHRAN, VRINDA	FACILITY NUMBER: 414004280
	VISIT DATE: 02/17/2023

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)
At 2:20PM., LPA inspected outside area. Backyard play area has accessible body of water. Safety gates with automatic shutting device has been in installed inside Area. Area is completely enclose, free of hazards or dangerous conditions.

At 2:30PM, LPA reviewed facility and children’s records were reviewed. Staff files included the Immunization Records; Employee Rights; Declaration to report Suspected Child Abuse (LIC9102).

Children’s files were reviewed and included the: Identification of Emergency Information (LIC700); Immunization Records; Notice of Parent's Rights (LIC995).

At 2:35PM., Based on record review and interviews, LPA confirmed licensee's 'Mandated Reporter Training' (AB1207) certification has expired.

LPA reminded licensee to update Cardiopulmonary Resuscitation (CPR)/ First Aid certifications.

LPA reminded licensee to conduct, and document emergency disaster drills once every 6 months. Advisory Note: Technical Violation (LIC9102TV) was issued.

Required posting are posted living room, including Childcare License, Notification of Parent’s Rights (PUB379), and Emergency Disaster Plan (LIC610A).

Per licensee, isolation of ill children is in playroom.

Per licensee, she provides all foods services for children in care. LPA reminded licensee to ensure all children’s meal containers brought by families should be labeled. Per licensee, home does not have firearms.

Licensee was reminded that all adults 18 years and over, living or working in the home, including employee and volunteers, must obtain criminal 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.

(REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

LIC809 (FAS) - (06/04)

Page: 4 of 5

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: MUSHRAN, VRINDA	FACILITY NUMBER: 414004280
	VISIT DATE: 02/17/2023

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)
LPA discussed the safe sleep regulations with licensee and discussed Child Care Licensing Safe Sleep Web page at:https://www.cdss.ca.gov/inforesource/child-care-licesning/public-information-and-resources/safe-sleep as an additional resource. LPA informed licensee of the importance of checking for recalled infant devices on United States consumer Product Safety Commission (CPSC) website at http://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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 tool, please send them 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/inforesource/community-care-licensing/inspection-process.

Based on today's inspection, deficiencies were observed in areas evaluated according to California Title 22, Div. 12 Chap. 3 Health and Safety Code of Regulations and cited on 809C. Exit interview, plan of correction, appeal rights, and report was discussed with Licensee, Vrinda Mushran, and signature of this form acknowledges receipt of these documents.

Notice of Site Visit was provided and must be posted for 30 days.

SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 02/17/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/17/2023

LIC809 (FAS) - (06/04)

Page: 5 of 5