414005063-11-28-2023-05-CC-CQUO-CY2238-20231128160155

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414005063
Report Date: 11/28/2023
Date Signed: 11/28/2023 04:02:02 PM

Document Has Been Signed on 11/28/2023 04:02 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:	GLORIOUS ACADEMY		FACILITY NUMBER:	414005063
ADMINISTRATOR:	JEN, SARAH		FACILITY TYPE:	830
ADDRESS:	2727 S. EL CAMINO REAL, #F		TELEPHONE:	(650) 671-8991
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY: 16	TOTAL ENROLLED CHILDREN: 0	CENSUS: 0	DATE:	11/28/2023
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	12:05 PM
MET WITH:	Sarah Jen		TIME COMPLETED:	04:30 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 November 28, 2023 at approximately 12:05pm, Licensing Program Analyst (LPA) Catrina Quimbo, conducted a scheduled pre-licensing inspection. LPA met with applicant, Sarah Jen, and explained the purpose of the inspection. No children were present during LPA's visit. Department received application November 1, 2023. Fire clearance for infant program was obtained November 17, 2023. The applicant is requesting a combination center of an infant program (3 months to 24 months) and a preschool program (2 years old to entry into first grade). Applicant is requesting for 16 infants and 85 preschool children. Applicant was reminded infant program and preschool program children must be kept physically separate and cannot co-mingle at any time. The preschool program will operate Monday through Friday 8:00am to 6:00pm. The designated director will be Sarah Jen. Facility includes 4 classrooms, an office space, children's bathroom, kitchen, and open multi-use space. The facility was inspected, indoors and outdoors, for health and safety hazards, and measured to calculate capacity. Children will be signed into and out of program by authorized representatives' written signatures. Applicant was reminded sign in/out sheets must be made readily available for review. Applicant was also reminded infant children must have an infant needs and services plan that must be updated with infants' families. Indoors: The infant program will operate in infant classroom #4 only. The infant program was measured for 366.13 sq. ft. allowing for a capacity of 10 children. LPA observed classroom to be well ventilated with appropriate temperature. Floor was observed to be new, in good condition. Applicant plans to utilize cubbies to store children's materials, that will be maintained in facility's hallways. (Continue Report on Page 2...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

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: GLORIOUS ACADEMY	FACILITY NUMBER: 414005063
	VISIT DATE: 11/28/2023

NARRATIVE

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Applicant plans to store poisons, cleaning supplies and hazardous materials in child safety locked cabinets, located in classroom. Facility is equipped with fully charged fire extinguishers. LPA observed facility to include a fire sprinkler system.

Medications with children’s individual names and required documentation will be stored in appropriate classrooms. Applicant is aware medications must be made inaccessible to children.

This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) tollfree 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, available at: http://www.ada.gov/childqanda.htm.

Applicant plans to provide young napping infants with cribs and older napping infants with cots. There is an area in infant classroom that will be designated for cribs only and was not measured as part of capacity. Applicant was reminded cribs must be free of loose articles and materials. Applicant plans to install a diaper changing station in classroom that will be within arm's reach to a sink. Sink can also be made accessible to infants if needed.

Applicant plans for isolation area to be in the office or open space, separate from other children in care. Program's discipline policy was discussed. Applicant plans to use redirection and communication with children's families. Applicant stated they are aware there can be no corporal punishment.

Applicant plans to provide a food service that includes morning snack, hot lunch and afternoon snack. Food will be prepared in kitchen that will be for staff use only. Applicant was reminded poisons and cleaning solutions shall not be stored in kitchen. Drinking water will be made available by children's individual water bottles. Children's water bottles can be refilled on site through filtered water pitchers.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

LIC809 (FAS) - (06/04)

Page: 2 of 4

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: GLORIOUS ACADEMY	FACILITY NUMBER: 414005063
	VISIT DATE: 11/28/2023

NARRATIVE

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Outdoor: Facility itself does not include an outdoor area. Applicant plans to utilize open space area, as the outdoor activity area. Applicant plans to utilize moveable wall partitions to separate preschool playground area, infant playground area, and additional classroom (used for preschool program).

Open space area includes poles that applicant plans to use as "marker" for wall partitions. LPA measured space as outdoor area based on pole markers. The infant playground area was measured for 745.78 sq. ft. allowing for a capacity of 9 children. LPA did not observe any bodies of water on site.

The requirement for Lead Water Testing was discussed (H&S Code 1597.16). Applicant was reminded all child care centers operating in a building constructed before 2010 must test their water for lead contamination. 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 reminded applicant emergency disaster drills must be documented when conducted. LPA reviewed with applicant/director, the LIC311A, Records to Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted. Applicant was also reminded sleeping logs for all infants under 24 months must be readily available for review. LPA provided applicant with PIN 20-24-CCP.

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Applicant was informed of the MyChildCarePlan.org site, 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.
(Continue Report on Page 4...)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: GLORIOUS ACADEMY	FACILITY NUMBER: 414005063
	VISIT DATE: 11/28/2023

NARRATIVE

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Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-carelicensing/ subscribe and select the Child Care option to receive email communication.

LPA discussed the safe sleep regulations with applicant 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 applicant 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.

Based on indoor square footage, maximum capacity infant program can be licensed for is 10 children.

Applicant was reminded any children not enrolled in preschool and infant program must be kept physically separate from preschool and infant enrolled children.

Prior to recommended licensure, following must be completed:
-Posting of all required licensing documentation.
-Installation of working carbon monoxide detector.
-Sound alarm system on exit door in infant classroom.
-Submission of all documents indicated on LIC184C.
-LPA's review and approval of resubmitted documents indicated on LIC184C.
-Management approval (open space as outdoor space).

Exit interview conducted and report was reviewed with the applicant, Sarah Jen.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 11/28/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/28/2023

LIC809 (FAS) - (06/04)

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