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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004816
Report Date: 03/25/2024
Date Signed: 03/25/2024 11:21:15 AM


Document Has Been Signed on 03/25/2024 11:21 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:WHOLE KID SCHOOLFACILITY NUMBER:
414004816
ADMINISTRATOR:DOAN, MICHELLEFACILITY TYPE:
830
ADDRESS:135 WILLOW ROADTELEPHONE:
(650) 382-9388
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY:8CENSUS: 2DATE:
03/25/2024
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
08:00 AM
MET WITH:Ilaise (Maufualu) MeliTIME COMPLETED:
09:30 AM
NARRATIVE
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On March 25th,2024, Licensing Program Analyst (LPA) Kassandra Medrano conducted an unannounced, case management inspection regarding lead testing for childcare centers. LPA met with Assistant Director, Ilaise Meli, and explained the purpose of the inspection. Present during visit included 2 infants and 1 staff. During review of fingerprint clearance it was found that the staff present were not associated to the facility, but have received criminal background clearances.

It was observed that facility provides children with filtered water to drink via personal water bottles. During conversation, it was stated that they do use faucet water to clean fruits and vegetables. It was also stated that filtered water gets delivered every couple weeks. During visit, director, Michelle Doan was out on vacation but called via telephone LPA Medrano to state that a lead testing was completed around 1/2022 and was sent into San Bruno Regional Office (SBRO). SBRO and the California water board have no documentation of this testing. As of this date, facility has not completed lead water testing that is in accordance with the Written Directives outlined in PIN 21-21.1-CCP. LPA referred facility representative to the Department website for lead: Toxicity Prevention and Water Testing Information.

LPA discussed Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the facility representative during the inspection. All Child Care Centers that are licensed in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

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, Ilaise Meli.

California Code of Regulations, Title 22 and Health & Safety Code deficiencies are being cited on the following page(s):
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 400-9920
LICENSING EVALUATOR SIGNATURE:
DATE: 03/25/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2024
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 2


Document Has Been Signed on 03/25/2024 11:21 AM - It Cannot Be Edited

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: WHOLE KID SCHOOL
FACILITY NUMBER: 414004816

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/25/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/25/2024
Section Cited
HSC
1597.16(a)(1)

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(a) (1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test.
This requirement was not met as evidenced by:
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Facility to complete lead testing or submit for a waiver for lead testing.
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Based on record review facility has not completed the required lead testing. This poses a potential health and safety risk to children in care.
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Type B
04/01/2024
Section Cited
CCR101170(e)(2)

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(e) All individuals subject to a criminal record review pursuant to Health and Safety Code Section 1596.871 shall prior to working, residing or volunteering in a licensed facility:(2)Request a transfer of a criminal record clearance as specified in Section 101170(f)
This requirement was not met as evidenced by:
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Facility to associate staff to proper program via guardian. or mail in LIC 9182 for SBRO to associate the staff
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Based on record review it was found that 5/7 staff were not associated to the facility. This poses a potential health and safety risk to children in care.
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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: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 400-9920
LICENSING EVALUATOR SIGNATURE:
DATE: 03/25/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/25/2024
LIC809 (FAS) - (06/04)
Page: 2 of 2