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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414005130
Report Date: 09/23/2024
Date Signed: 09/23/2024 02:17:58 PM

Document Has Been Signed on 09/23/2024 02:17 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:SAN MATEO-FOSTER CITY SCHL DIST-LAURELFACILITY NUMBER:
414005130
ADMINISTRATOR/
DIRECTOR:		CRISTINA HALEYFACILITY TYPE:
860
ADDRESS:316 36TH AVENUETELEPHONE:
(650) 312-7766
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY: 48TOTAL ENROLLED CHILDREN: 48CENSUS: DATE:
09/23/2024
TYPE OF VISIT:PrelicensingANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
10:30 AM
MET WITH:Director Amanda Driscoll, Teacher Ana GodinezTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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Centralized Application Bureau (CAB) Licensing Program Analyst (LPA) Jamel Maiwandi and Licensing Program Manager Mai Lor (LPA) met with Director of Child Development Amanda Driscoll and preschool teacher Ana Godinez for the purpose of an announced pre-licensing inspection at 316 36th Avenue, San Mateo, CA 94403 on 9/23/2024 at approximately 10:35am. Applicant Cristina Haley was not present during this inspection. Applicant requests a preschool component to serve 48 preschool children from age two years to entry into first grade in classroom #1 and #2. The preschool is located on the Laurel Elementary School ground. The program will operate Monday through Friday from 8:30 a.m. to 4:30 p.m. Fire clearance was granted on 09/11/2024.

LPA and LPM reviewed with applicant the LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted.

INDOOR ACTIVITY SPACE:
There are two preschool classrooms (classrooms 1 and 2), and a collaboration room located in between each classroom which will serve as the isolation area for sick children and will use one of the designated four toilets in the classrooms. As a back-up isolation area, the facility will utilize the main school office. There is a storage closet located in the collaboration room which will store napping cots and mats. The food preparation area is located in the school cafeteria as stated by Director of Child Development Amanda Driscoll. The preschool staff was reminded that all kitchen, food preparation and storage areas shall be kept clean and free of litter and rubbish; and measures shall be taken to keep all such areas free of rodents and other vermin. LPA and LPM measured the classrooms which includes a total of 1,573.32 square feet and will not accommodate the applicants request for 48 preschool children. LPA and LPM observed a sufficient amount of equipment, toys, tables, chairs, napping mats, and cubbies in each room. There is one first aid kit located in each classroom and one in the main entrance area as well.
Report continues on page LIC 809 page 2
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE: DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/23/2024
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 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: SAN MATEO-FOSTER CITY SCHL DIST-LAUREL
FACILITY NUMBER: 414005130
VISIT DATE: 09/23/2024
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Medications will be stored in locked cabinets in a separate area and inaccessible to children. Teacher Ana Godinez stated cleaning and disinfectant agents will be stored in locked cabinets and will be inaccessible to children. Teacher stated drinking water will be provided via drinking fountains and parents will provide drinking water as well. LPA and LPM observed a functional carbon monoxide detector in each classroom. Director Driscoll stated they will be using a paper sign in and sign out process and will transition to a digital sign-in and sign out process at a later time and will contact CCLD. Director stated outside of the facility, parents can drive up to the entrance and drop off the children or walk their child in through the entrance located next to the preschool outdoor playground. Director Driscoll stated preschool program will provide sheets, blankets and pillows, and parents will take these items home to wash every week. There is a total of four toilets and six sinks available for preschool children. In addition to the children’s sinks, there are two sinks for teachers (one in each classroom). There is a dedicated land line for the facility located in each preschool classroom. Director Driscoll and teacher Ana Godinez were informed facility shall be kept clean, safe, sanitary and in good conditions at all times to ensure the safety and well-being of children, employees and visitors. LPA and LPM observed separate private restrooms for the staff located on the elementary school.

OUTDOOR ACTIVITY SPACE:

There is one outdoor play area designated for the preschool children. During today’s inspection, LPA observed part of the fencing that separates the preschool yard from the elementary school yard under construction. A temporary fence is observed in lieu of the permanent fence. The Director stated the fencing should be completed by next week. Director Driscoll stated there will be pop up tents to provide shade while children are playing outdoors. Director Driscoll stated a permanent shade structure will be installed and the pop shade will be temporarily available The outdoor play area contains a total of 2,326.19 square feet and will accommodate the applicants request for 48 preschool children. LPA and LPM observed a sufficient amount of toys and play equipment. LPA and LPM observed sufficient resilient padding located under outdoor play structures. The outdoor play area is fenced by a white rod iron fence that is at least four feet tall. There is an additional entrance gate located next to the outdoor play area that can be utilized by parents during drop off and pick up times which leads to the parking lot. Per the director, the gate is locked from the outdoor and can only be open from the inside by a staff member. The director was reminded that the gate shall remain closed at all times during hours of operation to ensure the health and safety of children in care.

Report continues on LIC 809 page 3
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
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: SAN MATEO-FOSTER CITY SCHL DIST-LAUREL
FACILITY NUMBER: 414005130
VISIT DATE: 09/23/2024
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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) 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, available at: http://www.ada.gov/childqanda.htm

LPA discussed the following: 100% supervision is required at all times, including in the bathroom; personal rights; inspection authority; reporting requirements; staff to children ratios and capacity; staff qualifications; and maintaining buildings and grounds. LPA discussed with director any changes that may occur regarding the director or an employee acting in the director's absence must be reported to department within 10 working days.

Director 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.

Director 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.

Report continues on LIC809 page 4.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
LIC809 (FAS) - (06/04)
Page: 4 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: SAN MATEO-FOSTER CITY SCHL DIST-LAUREL
FACILITY NUMBER: 414005130
VISIT DATE: 09/23/2024
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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 platform. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

Assembly Bill (AB) 2370, /chapter 676, Statues 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-year 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)

Exit interview conducted and report was reviewed with the Director of Child Development Amanda Driscoll and Preschool Teacher Ana Godinez.

LPA will issue a provisional license that will expire 90- days on 12/22/2024. Once the provisional is issued, the following items are to be submitted prior to expiration of the provisional license for final approval of license:

1.Revised LIC 200A to reflect capacity of 44 children.
2.Submit classroom sketch with dimensions and label isolation space.
3.Department review of the parent handbook, employee handbook, admission agreement
4.Director verification for Ana Godinez Buenrostoro to include preventative health and safety training.
5. Revised fire clearance to reflect the capacity of 44 children
6. Submit photo of the completed fencing.
SUPERVISORS NAME: Mai Lor
LICENSING EVALUATOR NAME: Jamel Maiwandi
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2024
LIC809 (FAS) - (06/04)
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