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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004287
Report Date: 03/17/2022
Date Signed: 03/17/2022 01:22:04 PM


Document Has Been Signed on 03/17/2022 01:22 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:KIDS KONNECT PRESCHOOLFACILITY NUMBER:
414004287
ADMINISTRATOR:YU, FIEONFACILITY TYPE:
850
ADDRESS:2145 BUNKER HILL DRIVETELEPHONE:
(650) 315-2202
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:45CENSUS: 34DATE:
03/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Vanessa Nieves LabradaTIME COMPLETED:
01:35 PM
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On 3/17/2022 at 8:45A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with Director, Vanessa Nieves Labrada. Purpose of the inspection was explained and was for an unannounced, annual inspection. Present was the Director and 5 staff supervising 34 children. All children present had been signed in. Staff present had criminal record clearances on file. Preschool program utilizes two rooms: Multi-purpose Room and Art Room and the outdoor play area. Hours of operation are Monday- Friday 7:00am- 6:00pm. Program operates year around. LPA inspected facility, indoors and outdoors, with director for health and safety hazards.

At 9:00 A.M., the following was observed: Classrooms inspected were clean and orderly with age-appropriate books, wooden blocks and art supplies for the children. Floor and ground surfaces leading to the exits were free of obstructions. All furniture and playthings were in good repair. For storage, facility's multi-purpose classroom was equipped with several cubbies for children's belongings. Classrooms had several child sized tables and chairs. Fixtures tested in the children’s bathroom were in proper operating condition. Children's bathrooms had adequate supplies available. Per director, diaper changing table is disinfected after each use. Staff bathroom was located in facility hallway. For napping services, cleanable napping mats are stored in the art room. Per director, napping supplies are sent home to be washed every week. Classroom had acceptable ventilation and lighting. Cleaning detergents, supplies, spray bottles and all other toxins were made inaccessible, stored in hallway closet. Accessible outlets and trash bins had been properly covered. Facility had functioning smoke detector, carbon monoxide detector and fully charged fire extinguishers (3A:40BC). First aid kit and emergency disaster supplies were reviewed during inspection. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KIDS KONNECT PRESCHOOL
FACILITY NUMBER: 414004287
VISIT DATE: 03/17/2022
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At 9:30A.M., LPA inspected facility’s outdoor play area. Area was enclosed with tall fencing and was free of debris or other hazards. Outdoor playthings and tricycles were inspected and in good repair. For water services, children containers had been labelled and located on a moveable storage cart. Bottles are refilled from a non-contained source. Climbing structure was properly anchored and the shaded rest area was accessible. Soft rubber padding was installed for added safety.

At 10:00A.M., LPA review the facility records including ten children's files and six personnel files. Facility files reviewed included all staff’s: Criminal Record Statements (LIC508), Declaration to Report Suspected Child Abuse (LIC9108), Transcripts, Proof of Required Immunization and Notice of Employee Rights (LIC9052).

At 10:30A.M. Based on record review, LPA confirmed staff members, S1, required mandated reporter training certification had expired. During inspection, Advisory Note: Technical Assistance (LIC9102) was issued.

Children's files reviewed were complete. Required forms included children's Health History (LIC702), Identification of Emergency Information (LIC700), Consent for Medical Treatment (LIC627), Notification of Parent’s Rights (LIC995) and Immunization Records.

Staff had their current CPR. First Aid certification on file, expiring on 8/2022. Per director, required emergency drills are conducts every six months, with the last drill done on 2/9/2022, properly logged.

Per director, program provides all daily snack and meals. Facility kitchen was reviewed by LPA during inspection. Area was free of potential hazards. LPA reminded director to ensure any container brought from home are properly labelled with the child’s name. Required posting are posted in entry way, included the facility License, Notification of Parents Rights (PUB393), Emergency Disaster Plan (LIC610) and Updated Snack Menu.

During inspection, LPA reviewed children’s medication and IMS service plan on file. Medication reviewed had been properly stored and labelled.

Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: KIDS KONNECT PRESCHOOL
FACILITY NUMBER: 414004287
VISIT DATE: 03/17/2022
NARRATIVE
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

Based on today's inspection, no deficiencies were cited in the areas evaluated, according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with Director, Vanessa Nieves Labrado and her signature of this form acknowledges receipt of these documents.



The 'Notice of Site Visit' form was provided and must remain posted for 30 days.

This report and rights to comment were discussed. This report must be available in the facility for public review. For additional questions, facility was advised to contact the Community Care Licensing Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
LIC809 (FAS) - (06/04)
Page: 4 of 4