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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004670
Report Date: 12/12/2024
Date Signed: 12/12/2024 03:55:32 PM

Document Has Been Signed on 12/12/2024 03:55 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:PALCARE (TIDEPOOLS)FACILITY NUMBER:
414004670
ADMINISTRATOR/
DIRECTOR:		KIESSELBACH, LISAFACILITY TYPE:
830
ADDRESS:1001 CALIFORNIA DRIVETELEPHONE:
(650) 787-5477
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 18DATE:
12/12/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
01:00 PM
MET WITH:Director, Lisa KiesselbachTIME VISIT/
INSPECTION COMPLETED:
04:10 PM
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On December 12, 2024, at approximately 1:00 PM, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA met with the director, Lisa Kiessellbach, and explained the purpose of the visit.

Palcare Tidepools is an infant program. Program currently operates in its own building. The building consist of a play area #1, play area #2, play area #3, play area #4, kitchen, diaper changing area #1, diaper changing area #2/ laundry room, indoor outdoor play room, and outdoor area.

Hours of operation are Monday through Friday 6:30am to 7:00pm. Present during LPA's visit was the director, 18 infant children and 7 teachers. Preschool program is operating within capacity limits and ratio during LPA's visit.

LPA inspected facility, indoors and outdoors, for health and safety hazards. Play areas includes a variety of toys and materials that were in good condition. LPA observed play area to have age-appropriate furniture, equipment, and materials. LPA observed cleaning materials to be stored away, with child safety locks installed, inaccessible to children in care.

Per director, children sleep in play area #1, in mats. The center provides sheets and blankets. Per director, sheets and blankets are washed daily. Per director, mats are wiped down daily. LPA observed 15-minute sleeping logs to be maintained for infant children enrolled. Per director, children are enrolled starting at 3 months, up to 12 to 14 months. Per director, parents provide diapers and wipes for enrolled children.

Child care center was equipped with a fully charged fire extinguisher and first aid kit. LPA observed Carbon monoxide detectors and smoke alarm detector inside the building. The carbon monoxide detector and smoke alarm were located in high ceilings and are wired into the building. LPA was unable to test smoke and carbon monoxide alarm during visit. Storage for children's belongings is in classrooms. Childrens cubbies are labeled with children's individual names on it, and photo images.

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE: DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/12/2024
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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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: PALCARE (TIDEPOOLS)
FACILITY NUMBER: 414004670
VISIT DATE: 12/12/2024
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LPA observed both changing table areas. LPA observed two changing tables in each changing table area. There Is a sink between each changing table. LPA also observed trashcans with tight fitted lids. Childrens diapers are observed to be maintained, in a box, with the child’s name, and pictures on it. Per director, parents provide diapers. LPA observed no cleaning solutions, poisons, and other hazardous materials to be accessible to children.

Program does not provide a food service, because infant children bring infant food from home. Per director, children’s food is maintained in the kitchen. Childrens foods were observed to be stored and labeled. Per director, if a child has allergies, their label tag would be a different color. Lunch boxes have each child’s name and picture on it. LPA observed the refrigerator to have labeled bottled for each child, with their names on it, in their own container.

Facility has 2 outdoor space areas. The first area is the indoor/outdoor play area. Indoor/outdoor play area was observed to have cushion flooring. LPA observed toys and material to be in good condition. Second space is the outdoor area. Outdoor area is entirely enclosed and fenced. LPA observed outdoor play area to have cushion flooring, as well.

Program uses an electronic app for parents to sign in and out for their sign in/sign out system. Children were properly signed in during LPAs’ visit. LPA observed licensing posters and required documents to be properly posted inside the classroom. Program’s last disaster drills was conducted in October 2024.

LPA reviewed 8 facility staff records. LPA reviewed 6 random children facility records which were complete and had all required documents. Children's records have emergency information on file. Many staff on site have a current CPR/First Aid certification and mandated reporter certification. Staff records also include required immunizations that were made available for review.

Director was reminded all staff hired are required to 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 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

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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: PALCARE (TIDEPOOLS)
FACILITY NUMBER: 414004670
VISIT DATE: 12/12/2024
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Director 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.

CCC COMPLETED TESTING AND NO LEAD EXCEEDANCES:
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. 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 outlined in PIN 21-21.1-CCP.

Water quality was tested on 12/22/2022 and results complied. Lead water results were under the 5.5pbb threshold.

LPA's discussed the safe sleep regulations with director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

Director 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.

No deficiencies were cited today.

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

Exit interview conducted and report was reviewed with the director, Lisa Kiesselbach.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Melissa Zaragoza
LICENSING EVALUATOR SIGNATURE:

DATE: 12/12/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/12/2024
LIC809 (FAS) - (06/04)
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