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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004898
Report Date: 12/13/2024
Date Signed: 12/13/2024 11:18:25 AM

Document Has Been Signed on 12/13/2024 11:18 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:ANNE CAMPBELL CHILD DEVELOPMENT CENTERFACILITY NUMBER:
414004898
ADMINISTRATOR/
DIRECTOR:		JENNY JANE LAMFACILITY TYPE:
850
ADDRESS:65 TOWER ROADTELEPHONE:
(650) 802-5616
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 4DATE:
12/13/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Director, Jenny Jane LamTIME VISIT/
INSPECTION COMPLETED:
11:45 AM
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On December 13, 2024, at approximately 8:30 AM, Licensing Program Analyst (LPA) Melissa Zaragoza conducted an unannounced, annual inspection. LPA met with the director, Jenny Jane Lam, and explained the purpose of the visit.

Anne Campbell Child Development Center is a preschool age program. Preschool program is located inside the Anne Campbell building. Preschool program operates in 3 classrooms, room 2, room 3, and room 4. The only classrooms currently used are, room 3 and 2.

Hours of operation are Monday through Friday 8:00am to 5:00pm. Present during LPA's visit was the director, 4 preschool age children and 1 teacher. Program is operating within capacity limits and ratio during LPA's visit. All staff present have fingerprints and background check on file.

LPA inspected facility, indoors and outdoors, for health and safety hazards. Classroom includes a variety of toys and materials that were in good condition. LPA observed classroom to have age-appropriate furniture, equipment, and materials. LPA observed cleaning materials to be stored in high shelves, locked, inaccessible to children in care.

Per director, children nap while they are in preschool. Children sleep in cots. Per director, cots are wiped down daily, and stored in the classroom’s closets. Each cot was observed to have a name tag for each individual child. Per director, the childcare center provides the sheets, but children bring blankets from home. Per director, sheets and blankets are taken home weekly for wash.

The classroom is equipped with a fully charged fire extinguisher and first aid kit. LPA observed Carbon monoxide detectors and smoke detectors in the classrooms. Carbon monoxide detector was tested during visit and was observed to be working. LPA was unable to test smoke alarm, due to alarm being wired with the entire building. Storage for children's belongings is outside the classroom. Children's cubbies are labeled with children's individual pictures and name on it. LPA did not observe any accessible poisons or chemicals in the classrooms.

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Marie RodriguezTELEPHONE: (650) 266-8827
Melissa ZaragozaTELEPHONE: 650-266-8800
DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/13/2024
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 3
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: ANNE CAMPBELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004898
VISIT DATE: 12/13/2024
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There is one bathroom outside the classroom for the children. Bathroom for children was observed to be clean. Bathroom has 3 toilets and 1 sink. The sinks and toilet were in working condition. Bathroom was equipped with appropriate sanitation products. LPA observed bathroom to have 1 changing table, 1 adult sink, and trash can bins with a tight fighting lid. LPA observed children to have individual boxes in the bathroom with diapers. Per director, parents provide diapers and wipes. LPA observed no cleaning solutions, poisons, and other hazardous materials for to be stored in bathroom.

Program provides a food service of breakfast, lunch, and snack. Per director, they have a food provider, food is delivered daily by the San Mateo Foster City School District. Per director, children are also welcome to bring snack from home. There are currently no children enrolled, with allergies or dietary restrictions.

Outdoor area is entirely enclosed and fenced. LPA observed outdoor play area to have installed roof sunshades. LPA observed a play structure to have cushion flooring. LPA observed a sandbox to be fully covered. LPA observed toys and material to be in good conditions. Per director, children bring water bottles from home, and refill them in the classroom.

Program uses a form 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 on September, 2024.

LPA reviewed 2 facility staff records. LPA reviewed 4 children facility records which were complete and had all required documents. Children's records have emergency information on file. All 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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SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8827
LICENSING EVALUATOR NAME: Melissa ZaragozaTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2024
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: ANNE CAMPBELL CHILD DEVELOPMENT CENTER
FACILITY NUMBER: 414004898
VISIT DATE: 12/13/2024
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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.

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.

Water quality was tested on 01/06/2023 and results complied. Facilities license effective date was 08/09/2022. Facility tested for lead before 180 days of opening.

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.

There are no deficiencies 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, Jenny Jane Lam.
SUPERVISOR'S NAME: Marie RodriguezTELEPHONE: (650) 266-8827
LICENSING EVALUATOR NAME: Melissa ZaragozaTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/13/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/13/2024
LIC809 (FAS) - (06/04)
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