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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004754
Report Date: 04/16/2024
Date Signed: 04/16/2024 02:35:59 PM

Document Has Been Signed on 04/16/2024 02:35 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:L'ACADEMY PRESCHOOL SAN MATEOFACILITY NUMBER:
414004754
ADMINISTRATOR/
DIRECTOR:		RACHEL HENDRIXFACILITY TYPE:
850
ADDRESS:608 N. EL CAMINO REALTELEPHONE:
(415) 361-1879
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY: 32TOTAL ENROLLED CHILDREN: 32CENSUS: 25DATE:
04/16/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:43 AM
MET WITH:Leny HernandezTIME VISIT/
INSPECTION COMPLETED:
02:45 PM
NARRATIVE
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On 4/16/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Child Care Center (CCC) listed above. This facility also operates an infant program under license number 414005049. LPA met with the Assistant Director, Leny Hernandez, and explained the purpose of the visit. Eight toddlers, seventeen preschool-aged children, and five staff members were present during the visit. The five staff members present at the CCC have all received criminal record clearance from the department.

LPA observed that all required documents, such as the facility license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities, were displayed in the CCC. LPA observed that the last emergency disaster drill was conducted on 2/16/2024 and properly recorded.

According to the Assistant Director, the CCC provides lunch and snacks for the children. LPA reminded the Assistant Director about the importance of sanitation and proper food preparation.

LPA observed that the CCC maintains an electronic record of the children’s attendance, with corresponding parental signatures, and all enrolled children are accounted for during the day.

LPA and the Assistant Director conducted an inspection to identify potential health and safety hazards. LPA observed that the inside of the CCC was clean, safe, sanitary, and in good repair. The CCC is equipped with a fully stocked first aid kit, functioning smoke and carbon monoxide detectors, and a fully charged fire extinguisher.

LPA observed there was a safety gate between the two classrooms, as required for having a preschool and a toddler program

LPA observed that the classrooms were equipped with age-appropriate toys, furniture, and educational materials. LPA observed that each child has an individual permanent or portable storage space for his/her clothing and personal belongings at the CCC.
See Page 2
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/16/2024
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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Document Has Been Signed on 04/16/2024 02:35 PM - It Cannot Be Edited


Created By: Hanson Leong On 04/16/2024 at 12:14 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: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
CCR
101238(g)
Buildings and Grounds
(g) Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, which poses an immediate health, safety or personal rights risk to children in care.
POC Due Date: 04/17/2024
Plan of Correction
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The Assistant Director stated that she will purchase child safety latches for the lower cabinets or install a child safety gate. A follow-up visit will be required to clear the deficiency.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
Page: 2 of 8
Document Has Been Signed on 04/16/2024 02:35 PM - It Cannot Be Edited


Created By: Hanson Leong On 04/16/2024 at 12:14 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: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 05/16/2024
Plan of Correction
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The Assistant Director stated that she would provide immunization records of all staff members who were missing the required immunizations to be in a child care center. A follow-up visit will be required to clear the deficiency.


Type B
Section Cited
CCR
101216.1(c)(1)
Teacher Qualifications and Duties
(c) To be a fully qualified teacher, a teacher shall have one of the following: (1) Twelve postsecondary semester or equivalent quarter units in early childhood education or child development completed, with passing grades, at an accredited or approved college or university; and at least six months of work experience in a licensed child care center or comparable group child care program.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 05/16/2024
Plan of Correction
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The Assistant Director stated a new staff member will start and has the required twelve ECE units,
The Assistant Director stated that the missing transcripts would be obtained from the present staff members.
A follow-up visit will be required to clear the deficiency

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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
Page: 3 of 8
Document Has Been Signed on 04/16/2024 02:35 PM - It Cannot Be Edited


Created By: Hanson Leong On 04/16/2024 at 12:14 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: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101216.3(b)(1)
Teacher-Child Ratio
(b) The licensee may use teacher aides in a teacher-child ratio of one teacher and one aide for every 15 children in attendance. (1) A ratio of one fully qualified teacher (as specified in Section 101216.1(c) and one aide for every 18 children in attendance in a preschool program is allowed when the aide meets the qualifications specified in Section 101216.2(d).

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, interview, and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 05/16/2024
Plan of Correction
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The Assistant Director stated a new staff member will start and has the required twelve ECE units,
The Assistant Director stated that the missing transcripts would be obtained from the present staff members.
A follow-up visit will be required to clear the deficiency
Type B
Section Cited
CCR
101216.4(a)(2)
Preschool Program with Toddler Component
(2) The toddler program shall be conducted in areas physically separate from those used by older or younger children. Space planning and usage for the toddler component shall be governed by the provisions of Section 101438.3. Plans to alternate use of outdoor play space must be approved by the Department.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 05/16/2024
Plan of Correction
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The Assistant Director stated that she would create a schedule for the two different age groups.
A follow-up visit will be required to clear the deficiency
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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


LIC809 (FAS) - (06/04)
Page: 4 of 8
Document Has Been Signed on 04/16/2024 02:35 PM - It Cannot Be Edited


Created By: Hanson Leong On 04/16/2024 at 12:14 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: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 04/16/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101429(a)(2)(C)(3)
Responsibility for Providing Care and Supervision for Infants
(C) Documentation shall be maintained in the infant’s file and be available to the Department for review. Documentation shall include the following: (3) Time of each 15-minute check

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on interview and record review, the licensee did not comply with the section cited above, which poses/posed a potential health, safety or personal rights risk to children in care.
POC Due Date: 05/16/2024
Plan of Correction
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3
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The Assistant Director stated that she would start using the sleep log for children under the age of two that was provided during the visit. A follow up visit will be required to clear the deficiency.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Hanson Leong
LICENSING EVALUATOR SIGNATURE:
DATE: 04/16/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/16/2024


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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: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754
VISIT DATE: 04/16/2024
NARRATIVE
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LPA observed the bathroom to be clean and in working condition. The bathroom garbage bins were observed to have tight-fitting lids. The sink was observed to be in working condition and not providing water warmer than 120 degrees Fahrenheit. LPA observed that the toilets and handwashing facilities at the CCC were in safe and sanitary operating condition.

LPA observed that all accessible classroom cabinets and drawers did not contain hazardous materials or poisons. During the visit, LPA observed that poisons, cleaning solutions, and chemicals such as pine sol, bleach, dish detergent, disinfectant spray, and hydrogen peroxide solution were stored inside the lower cabinets of the kitchen, which children used as a passageway to the outdoor play area.

LPA observed that a fence enclosed the outdoor playground, and the equipment and furniture were in good condition. The areas around and under high climbing equipment, swings, slides, and similar equipment were cushioned with material that absorbs falls. LPA observed that children of two different groups were in the playground at the same time, which Is a violation of the outdoor waiver.

LPA reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information. According to the Assistant Director, the CCC does not use a sleeping log for children under the age of two. During the visit, a sleeping log template was given to the Assistant Director.

LPA reviewed the files of five staff members and found that one staff member was current with their Pediatric First Aid/CPR certifications. LPA reviewed the transcripts of five staff members and found that the Assistant Director is the only staff member with the twelve required Early Childhood Education (ECE) units, a requirement to become a qualified teacher. The CCC is not operating within the required staff-to-child ratio.

LPA reviewed the five staff members' immunization records and found that three staff members' immunization records were missing from their files.

LPA observed two staff members in each classroom did not possess the required twelve ECE units. LPA also observed the Assistant Director supervising both classrooms.
See Page 3
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754
VISIT DATE: 04/16/2024
NARRATIVE
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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.

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.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes 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) 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


See Page 4
SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: L'ACADEMY PRESCHOOL SAN MATEO
FACILITY NUMBER: 414004754
VISIT DATE: 04/16/2024
NARRATIVE
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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

The LPA informed the Assistant Director to provide a copy of this licensing report dated 4/16/2024 that documents any Type A citations to the parents or guardians of all children currently enrolled by the next business day or the next day the children are in care and to the parents or guardians of any newly enrolled children for a period of 12 months from the date of this report. The deadline for providing this information is the next day, 4/17/2024, the children are in care. For the purposes of verification, the child's file needs to have either a signed Acknowledgement of Receipt of Licensing Report (LIC 9224) or another type of written statement.

Please refer to LIC 809D for today’s citations.

Appeal Rights were given to the Assistant Director, Leny Hernandez.

LIC 809D (Type A violation) was given and must remain posted for 30 days.

A Notice of Site Visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Assistant Director, Leny Hernandez.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 04/16/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/16/2024
LIC809 (FAS) - (06/04)
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