414005146-9-18-2025-05-CC-MOLN-DLMVQL-20250918163832

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414005146
Report Date: 09/18/2025
Date Signed: 09/18/2025 04:39:00 PM

Document Has Been Signed on 09/18/2025 04:39 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:	REDWOOD CHURCH PRESCHOOL		FACILITY NUMBER:	414005146
ADMINISTRATOR/ DIRECTOR:	KAREENA CAMPBELL		FACILITY TYPE:	860
ADDRESS:	901 MADISON AVENUE		TELEPHONE:	(650) 562-7611
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY: 82	TOTAL ENROLLED CHILDREN: 54	CENSUS: 38	DATE:	09/18/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	11:23 AM
MET WITH:	Assistant Director Adelaida Jackson		TIME VISIT/ INSPECTION COMPLETED:	05:00 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 September 18, 2025, at approx. 11:25am Licensing Program Analyst (LPA) Maria Olguin-Leon conducted an unannounced, annual inspection. LPA met with Assistant Director Adelaida Jackson and explained the purpose of the inspection. Present in the facility today was the Assistant Director and 10 staff caring for 38 children (6 toddlers & 32 preschoolers). All adults working at the facility have criminal background clearances and associated to facility. LPA observed Kiwi preschool classroom and toddler classroom commingling in the preschool classroom. Type B deficiency was issued as this poses a potential health and safety hazard to children in care. The facility operates preschool program with a toddler option. Facility operates year-round. Hours and days of operation are Monday to Friday 7:30am to 5:30pm. Assistant Director and LPA toured the indoors and outdoors of the facility for health and safety hazards. Facility operates on the site of Redwood Church. The toddler program operates in portable #B and the preschool program operates in 5 classrooms in the two story building. Preschool classrooms are Plum #1 (2 ½-3 ½ yrs. old), Kiwi #2 (2-3 yr. old), which are located on first floor of building and #3 Mango (3 ½-4 ½ yrs. old), #4 Apple (older 4 yrs. olds) & #5 Pineapple (pre-K) are located on the second floor. Classrooms are clean and organized with proper temperature and ventilation. There are plenty of age-appropriate toys, child size furniture, learning materials, indoor dramatic play areas, and sleeping cots all in good repair. Storage hooks and storage cubbies are available for children to store personal items and belongings. There are two separate restrooms on site for children’s use with working toilets and sinks with no running hot water. There is a separate restroom on site for staff use. LPA reminded Assistant Director to have tight fitting lids on all trash containers. All cleaning products, chemicals and toxins are stored and locked in a cabinet and inaccessible to children. The facility has plenty of sleeping cots available for napping and the facility provides sheets which are washed on a weekly basis and children bring their own bedding. Cont. Page 2...

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

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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California Health & Human Services Agency

California Department of Social Services

FACILITY EVALUATION REPORT California law requires a public report of each licensing visit/inspection. This report is a record for the facility and the licensing agency. This report is available for public review; therefore, care is taken not to disclose personal or confidential information. Inquiries concerning the location, maintenance, and contents of these reports may be directed to the Licensing Program Analyst or Regional Office whose address and telephone number are listed on the front of this form.

DEFICIENCIES A deficiency is an instance of noncompliance with licensing requirements, including applicable statutes, regulations, interim licensing standards, operating standards, and written directives. Applicants/ licensees must be notified in writing of all licensing deficiencies. Deficiencies are listed on the left side of this form, and the applicable licensing requirement upon which the deficiency is identified. There are two types of deficiencies:

Type A deficiencies are violations of licensing requirements that, if not corrected, have a direct and immediate risk to the health, safety, or personal rights of persons in care.

Type B deficiencies are violations of licensing requirements that, without correction, could become a risk to the health, safety, or personal rights of persons in care, a recordkeeping violation that could impact the care of said persons and/or protection of their resources, or a violation that could impact those services required to meet the needs of persons in care.

PLANS OF CORRECTION (POCs) The licensing agency is required to establish a reasonable length of time to correct a deficiency. In order to set the time, the licensing agency must take into consideration the seriousness of the violation, the number of persons in care involved, and the availability of equipment and personnel necessary to correct the violation. Applicants/licensees are requested to provide a specific plan for each violation on the right side of the form across from each deficiency. The more specific the plan, the less chance exists for any misunderstanding in setting time limits and reviewing corrections. The applicant/licensee who encounters problems beyond their control in completing the corrections within the specified time frame may request and may be granted an extension of the correction due date by the licensing agency.

CORRECTION NOTIFICATION The applicant/licensee is responsible for completing all corrections and promptly notifying the licensing agency of corrections. Applicants/licensees are advised to keep a dated copy of any correspondence sent to the licensing agency concerning corrections, or if corrections are telephoned to the licensing agency, the date, person contacted, and information given.

CIVIL PENALTIES The licensing agency is required by law to issue a Penalty Notice, when applicable, to all facilities holding a license issued by the licensing agency, or subject to licensure, except Certified Family Homes, Resource Families, and Foster Family Homes, or any governmental entity.

PENALTY NOTICE GIVEN The statement concerning civil penalties serves as a penalty notice on this Licensing Report and failure to correct cited licensing deficiencies will result in civil penalties. Applicants/ licensees are required to pay civil penalties when administrative appeals have been exhausted and in accordance with any payment arrangements made with the licensing agency.

APPEAL RIGHTS The applicant/licensee has a right without prejudice to discuss any disagreement in this report with the licensing agency concerning the proper application of licensing requirements. The applicant/ licensee may request a formal review by the licensing agency to amend or dismiss the notice of deficiency and/ or civil penalty. Requests for review shall be made in writing within 15 business days of receipt of a deficiency notification or civil penalty assessment. Licensing deficiencies may be appealed pursuant to the procedures in the LIC 9058 Applicant/Licensee Rights.

AGENCY REVIEW The licensing agency review of an appeal may be conducted based upon information provided in writing by the applicant/licensee. The applicant/licensee may request an office meeting to provide additional information. The applicant/licensee will be notified in writing of the results of the agency review within 60 business days of the date when all necessary information has been provided to the licensing agency.

EMAIL REQUIREMENT Adult Community Care Facilities, Residential Care Facilities for the Chronically Ill, and Residential Care Facilities for the Elderly are required to provide and maintain an active email address of record with the licensing agency.

LIC809 (FAS) - (09/23)

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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: REDWOOD CHURCH PRESCHOOL	FACILITY NUMBER: 414005146
	VISIT DATE: 09/18/2025

NARRATIVE

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There is an outdoor area for preschoolers and one for toddlers. The preschool playground has a large slide structure, a swing set, a sand area and other age-appropriate toys, all in good condition. Flooring under play areas is artificial grass and tanbark to cushion falls. The preschool playground is enclosed with a 5 ft. chain, link fence and key lock gate. The toddler program playground has small play slides, playhouse, a sand box area, child size furniture and other age-appropriate toys, all in good condition. The toddler area is equipped with artificial grass. Toddler playarea is surrounded with a fence. LPA observed umbrellas and sunshade for providing shade to children in care. LPA did not observe any pools, spas, or other similar bodies of water on the premises.

Children bring their own lunches from home and the facility provides a morning snack. LPA observed menus posted. LPA observed kitchen to be clean, and food properly stored to prevent spoilage or contamination. Children bring their own water bottles from home and are labeled with children’s names. Facility refills water bottles with Brita filtered water pitchers. First aid kit is fully stocked with medical supplies. Incidental Medical Services were discussed and reviewed. Sick children are isolated in the office away from other children. Per Director, there are no weapons or firearms on the premises.

LPA reviewed electronic sign in/out via Bright wheel app. Parents sign children in and out using the QR code. Parents have their own unique PIN# and use electronic signature. Classrooms have a working carbon monoxide detector and smoke detectors are integrated into the sprinkler system. There is a landline in the office and staff use cell phones and walkie talkies for communication and for emergencies.

LPA reviewed 5 children’s files and 5 staff files. The facility has all necessary paperwork posted, Facility License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Weekly menus, and Emergency Disaster Plan. Per Assistant Director, the last emergency drill was conducted on August 2025, LPA reminded the facility to properly document drills.

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/.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

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: REDWOOD CHURCH PRESCHOOL	FACILITY NUMBER: 414005146
	VISIT DATE: 09/18/2025

NARRATIVE

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Assistant 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.

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 has an approved lead testing attestation.

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

Assistant Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

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: REDWOOD CHURCH PRESCHOOL	FACILITY NUMBER: 414005146
	VISIT DATE: 09/18/2025

NARRATIVE

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Assistant 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.

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

See page LIC809D for a type ‘B” deficiency issued today, under title 22.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements may result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the Assistant Director, Adelaida Jackson.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Maria Olguin-Leon
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 09/18/2025 04:39 PM - It Cannot Be Edited

Created By: Maria Olguin-Leon On 09/18/2025 at 04:16 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: REDWOOD CHURCH PRESCHOOL	FACILITY NUMBER: 414005146
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 09/18/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101161(a)

Limitations on Capacity and Ambulatory Status

(a) A licensee shall not operate a child care center beyond the conditions and limitations specified on the license, including the capacity limitation. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and interviews, the licensee did not comply with the section cited above in toddler age children were commingling with the preschool children. LPA observed toddler children have lunch with preschool children in a preschool classroom. [count] out of [total count] [(objects) (persons)] [identifiers] which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 09/22/2025
	Plan of Correction
1 2 3 4	Assistant Director will have a staff meeting regarding commingling of children. Assistant Director will email agenda to LPA with staff signature in attendance. During LPA's visit toddler children were taken back to their respective classroom.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 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.

	Marie Rodriguez
NAME OF LICENSING PROGRAM MANAGER:

	Maria Olguin-Leon
NAME OF LICENSING PROGRAM ANALYST:

LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 09/18/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/18/2025

LIC809 (FAS) - (06/04)

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