384001884-3-7-2024-05-CC-BVAN-D363YP-20240307174016

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384001884
Report Date: 03/07/2024
Date Signed: 03/07/2024 05:40:24 PM

Document Has Been Signed on 03/07/2024 05:40 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SFSU - CHILDREN'S CAMPUS (PRESCHOOL)		FACILITY NUMBER:	384001884
ADMINISTRATOR:	GONZALEZ, ITZA		FACILITY TYPE:	850
ADDRESS:	5N STATE DR. LAKE MERCED BLVD.		TELEPHONE:	(415) 405-4011
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94132
CAPACITY:	42	CENSUS: 14	DATE:	03/07/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	02:15 PM
MET WITH:	Itza Gonzalez		TIME COMPLETED:	05:45 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 March 7, 2024, Licensing Program Analyst (LPA) Van met with Director Itza Gonzalez for an unannounced required random inspection. The purpose of the inspection was explained, and the Director granted LPA entry to the facility. The center is a combination center with an infant program and a preschool program. Both programs operate under a separate license. Two teachers and a director supervised 14 preschool children today. The facility complies with the staff-children ratios today. All staff members who were present during the inspection had criminal record clearance verified with the CDSS Guardian Background check site. The days and operations hours are Monday - Friday from 7:30 a.m. to 5:30 p.m. During the inspection, LPA and the Director thoroughly examined the physical plant to identify potential health and safety hazards. The preschool operates in rooms #112 and #114. Per the director, due to low enrollment this year, room #114 is not used but is used as storage. The facility has a manual sign-in and out, and upon review, the record showed that all parents' signatures matched and accounted for the number of children present. The facility is in good condition, and the temperature and ventilation levels are adequately maintained. Age-appropriate toys and educational materials are available in each classroom. The furniture is sturdy and well-maintained. LPA observed that each child has a cubby available with their name labeled. Multiple fully charged fire extinguishers with 2A 10 BC specifications and a functioning telephone are available. The Center also has a centralized smoke alarm and a carbon monoxide detector. Emergency supplies are stored in locked storage, and first aid supplies are fully stocked and available for children's use. Continued on page 2...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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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Document Has Been Signed on 03/07/2024 05:40 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFSU - CHILDREN'S CAMPUS (PRESCHOOL)	FACILITY NUMBER: 384001884
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/07/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on the interview and record review, the licensee did not comply with the above-referenced section. Water fixtures were not tested for lead before the due date of January 1, 2023, which poses a potential health, safety, or personal rights risk to persons in care.
	POC Due Date: 03/29/2024
	Plan of Correction
1 2 3 4	The Center completed its water test on May 6, 2023, and lead testing results show that the water fixtures are below the 5.5 ppb threshold. The deficiency is cleared today.

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.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFSU - CHILDREN'S CAMPUS (PRESCHOOL)	FACILITY NUMBER: 384001884
	VISIT DATE: 03/07/2024

NARRATIVE

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All hazardous materials, including cleaning solutions and poisons, are kept inside a locked storage room, inaccessible to children. Medications are stored in the classroom with children who require them. LPA noticed that the medication was safely stored in a lock-and-key metal box and in its original container. The Center maintains a separate binder that contains all the necessary parental consent forms.
All toilets and handwashing sinks are in good working condition and have proper sanitation.

The outdoor play area is kept clean and free of debris. It is also completely fenced, clean, and in good repair. All play structures, such as climbing and sliding, have soft rubber cushions underneath to prevent accidental falls. LPA reminded the Director that drinking water should be available and freely accessible.

LPA observed no swimming pools, spas, or fishponds. While inspecting the outdoor playground fence, LPA noticed a drainage ditch with several small standing water puddles due to leaves and debris. LPA reminded the Director about the importance of completely draining all standing water, especially after a long period of rain.

During the inspection, LPA reviewed records of children and personnel. The records for each child were found to be complete, including their names, addresses, and authorized representative telephone numbers. Each child's file also contains information about their immunization record, medical assessment, and admission agreement. Staff members' records showed that all individuals requiring caregiver background checks had undergone criminal records and child abuse index clearances or exemptions. Several teachers possess valid CPR certificates. LPA reviewed the educational qualifications of the staff members and confirmed that everyone had completed the required ECE units and mandated reporter training.

The Center conducted its fire and earthquake drills monthly, with the most recent drill completed on 2/28/2024.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFSU - CHILDREN'S CAMPUS (PRESCHOOL)	FACILITY NUMBER: 384001884
	VISIT DATE: 03/07/2024

NARRATIVE

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The facility had posted the required forms. (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). The director stated that the center provides only AM and PM snacks. Children bring lunch from home. Per the Director, the children bring their water bottles from home. The facility also has a water filtration pitcher available for children to refill indoors and outdoors if needed. All storage containers for solid waste within the Center have a proper tight-fitting cover.

The 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The Director was informed about Mandated Reporter training AB 1207. The Mandated Reporter AB 1207 training must be completed every two years by the Licensee and for all staff hired. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SFSU - CHILDREN'S CAMPUS (PRESCHOOL)	FACILITY NUMBER: 384001884
	VISIT DATE: 03/07/2024

NARRATIVE

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The Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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.

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE.

The Center conducted its water lead testing on May 6, 2023. As a result, a deficiency was issued today. However, the deficiency is cleared on the same day.

LPA verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

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).

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 LIC 809D for deficiency cited during the inspection.

A notice of site visit was given to the director, and it must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days.

An exit interview was conducted, and the report was reviewed with the Director, Itza Gonzalez.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/07/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/07/2024

LIC809 (FAS) - (06/04)

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