414005219-5-12-2025-05-CC-CQUO-DGLQWK-20250512123205

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414005219
Report Date: 05/12/2025
Date Signed: 05/12/2025 12:32:18 PM

Document Has Been Signed on 05/12/2025 12:32 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:	KIDS KONNECT PACIFICA		FACILITY NUMBER:	414005219
ADMINISTRATOR/ DIRECTOR:	RIA AGUINALDO		FACILITY TYPE:	860
ADDRESS:	2450 SKYLINE DRIVE		TELEPHONE:	(650) 359-4321
CITY:	PACIFICA	STATE: CA	ZIP CODE:	94044
CAPACITY: 42	TOTAL ENROLLED CHILDREN: 45	CENSUS: 41	DATE:	05/12/2025
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Jheel Jawharkar		TIME VISIT/ INSPECTION COMPLETED:	12:45 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 May 15, 2025 at approximately 9:00am, Licensing Program Analyst (LPA) Catrina Quimbo conducted a scheduled, pre-licensing visit to Kids Konnect Pacifica. LPA met with applicant, Jheel Jawharkar, and facility director, Ria Aguinaldo, and explained the purpose of the visit. Present during LPA's visit included 7 teaching staff and 41 children (12 toddlers and 29 preschool age). Teaching staff present have fingerprint clearance on file. This is a change of ownership application. Facility is currently licensed and operating under license number 414002390. Applicant submitted application to the department March 6, 2025. Applicant is requesting for a total licensed capacity of 42 children with a preschool program and toddler component. Applicant is requesting for 12 toddlers (18 months to 36 months) and 30 preschool children (2 years to entry into first grade). Per applicant and director, fire department inspection has been completed. Department has not received fire clearance as of this date. The facility will operate Monday through Friday. Preschool component hours are 7:30am to 5:30pm while toddler component hours are 8:00am to 5:30pm. Facility includes 3 classrooms, 2 children's restrooms, an adult restroom, kitchen, staff room, director's office, and outdoor area. Children will utilize the 3 classrooms, 2 children's restrooms and outdoor area only. Kitchen, staff room and director's office are to be off limits for children. The facility was inspected indoors and outdoors, for health and safety hazards, and measured to calculate capacity. Indoors: There is 1 classroom for the toddler component: "Nemo"-Classroom A (18 months to 36 months). There are 2 classrooms for the preschool component: "Dolphin"-Classroom B and C (3.5 years old to kindergarten/TK age) and "Jellyfish"-Classroom D (3 years to 4.5 years old). Total indoor square footage equals 1,623.21 sq. ft. allowing for a capacity of 46 children. (Continue Report on Page 2...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025

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: KIDS KONNECT PACIFICA	FACILITY NUMBER: 414005219
	VISIT DATE: 05/12/2025

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LPA observed Nemo classroom to be ventilated with appropriate temperature. Classroom includes rugs that are new, clean and free of stains. Per director, all rugs in facility are vacuumed daily. LPA observed toddler classroom to have a variety of toys and materials that are age appropriate and in good condition. There is soft padding play in the classroom that was observed to be clean. Per director, toys and materials are sanitized weekly or as needed. LPA observed electrical outlets in classroom to be made inaccessible with child safety locks.

There is a children's restroom in Nemo classroom, separate from preschool children, that includes a diaper changing table. LPA observed diaper changing table to be within arm's reach to a sink. LPA also observed children's diapers and wipes to be stored appropriately, labeled with children's individual names.

Toys and furniture are age appropriate. Toddler children sleep on floor mats. Sheets and blankets are provided by children's families. LPA observed children's sheets and blankets to be stored appropriately so that sheets are not touching each other.

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.

Preschool classrooms include a variety of toys and materials that are also in good condition. Per applicant, toys and materials are sanitized weekly or as needed. Storage for children's belongings will be maintained in cubbies, labeled with children's individual names. Furniture and equipment for preschool children are age appropriate. Preschool children will also sleep on cots with sheets and blankets that will be sent home weekly for laundering, or as needed.

Children's restroom for preschool children is located in the Jellyfish classroom. Preschool component includes 3 sinks and 3 toilets. Toddler component includes 3 sinks and 2 toilets. Total allowable capacity for toilets is 75 children. Total allowable capacity for sinks is 90 children. LPAs observed sinks and toilets to be in proper working condition. Per director, sinks do not provide hot water. There is another diaper changing table in the preschool classroom, if needed. Director stated they are aware children must always be supervised when going to and from the restroom. LPA observed garbage bins in restroom and classrooms to also have a tight fitting lid.
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NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025

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: KIDS KONNECT PACIFICA	FACILITY NUMBER: 414005219
	VISIT DATE: 05/12/2025

NARRATIVE

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LPA observed facility includes multiple, fully charged fire extinguishers, multiple smoke detectors and multiple carbon monoxide detectors. LPA observed detectors to be in facility's high ceilings. Director maintains documentation that detectors have been tested recently and are in working condition. LPA observed each classroom to also include an emergency backpack that includes emergency contact information, a fully stocked first aid kit and emergency medication. There is a refrigerator in the kitchen if medication requires refrigeration.

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.

There is a kitchen and staff room that is made off limits to children. LPA advised director to install a door handle with a child safety lock handle.

Program will provide a food service that includes morning snack, lunch and afternoon snack. Reusable utensils are utilized and sanitized daily in facility's dishwasher. LPA observed food and storage to be appropriately stored, labeled with dates.

Children will drink water from their individual water bottles, that are labeled. Drinking water is available on site with a dispenser that can be refilled through kitchen's sink.

The requirement for Lead Water Testing was discussed (H&S Code 1597.16). Applicant was reminded a facility licensed after July 1, 2022, must have their water fixtures (used for drinking and food preparation) tested for lead 180 days after licensure and every 5 years thereafter. LPA advised applicant to review PIN 21-21-CCP.

Isolation area will be in the director's office, separate from other children in care. Director stated they are aware children must always be supervised. Program's discipline policy was discussed. Program plans to speak with children about their emotions and problem solving.
(Continue Report on Page 4...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025

LIC809 (FAS) - (06/04)

Page: 4 of 6

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: KIDS KONNECT PACIFICA	FACILITY NUMBER: 414005219
	VISIT DATE: 05/12/2025

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Outdoor: Outdoor area is located directly outside Jellyfish classroom. Total outdoor area was measured for 3,110.05 sq. ft. allowing for a capacity of 41 children. Outdoor area is fully enclosed and fenced. There are fences in the outdoor area, separating the toddler component and preschool component. LPA observed a play structure in the outdoor area with resilient padding underneath. Flooring in outdoor area includes artificial turf that is in good condition. There is a sandbox in the outdoor area. Per director, outdoor toys and materials are sanitized weekly or as needed. LPA did not observe a pool, spa or bodies of water on site. Applicant will submit an outdoor rotation waiver request to department.

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

Staff communicate with children's families via an electronic application. Sign in/out records are maintained through electronic application as well. Children's authorized representatives sign their children into and out of program through electronic signatures. Per applicant, staff verify individuals' identity through photo identification. Director stated printed sign in/out sheets are also available as a backup, if needed.

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.

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.
(Continue Report on Page 5...)

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025

LIC809 (FAS) - (06/04)

Page: 5 of 6

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: KIDS KONNECT PACIFICA	FACILITY NUMBER: 414005219
	VISIT DATE: 05/12/2025

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Applicant was reminded children participating in the toddler option component, must have written authorization from the child's authorized representative prior to enrollment in toddler program.

Based on indoor square footage, maximum capacity program can be licensed for is 46 children (toddler component not to exceed 12 children).

The following corrections are needed prior to the issuance of the license:
-Fire clearance.
-Submission for outdoor rotation waiver.
-Centralized Application Bureau (CAB) final approval of application.

Applicant, Jheel Jawharkar, understands that all proof of corrections must be provided to the Department within 30 days, or the application may be denied.

Exit interview conducted and report was reviewed with applicant, Jheel Jawharkar.

NAME OF LICENSING PROGRAM MANAGER: Marie Rodriguez
NAME OF LICENSING PROGRAM ANALYST: Catrina Quimbo
LICENSING PROGRAM ANALYST SIGNATURE:	DATE: 05/12/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2025

LIC809 (FAS) - (06/04)

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