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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210105818
Report Date: 06/04/2026
Date Signed: 06/04/2026 12:53:06 PM

Document Has Been Signed on 06/04/2026 12:53 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:ABC ACADEMY PRESCHOOLFACILITY NUMBER:
210105818
ADMINISTRATOR/
DIRECTOR:		SHAW, LAURENFACILITY TYPE:
850
ADDRESS:176 TUNSTEAD AVENUETELEPHONE:
(415) 459-7611
CITY:SAN ANSELMOSTATE: CAZIP CODE:
94960
CAPACITY: 40TOTAL ENROLLED CHILDREN: 31CENSUS: 26DATE:
06/04/2026
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Monika Rastehgar and Lauren Rey (Shaw)TIME VISIT/
INSPECTION COMPLETED:
01:00 PM
NARRATIVE
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On June 4, 2026, Licensing Program Analyst (LPA) Van conducted an unannounced annual inspection and met with Lead Teacher Monika Rastehga, who granted entry to the facility. The purpose of the inspection was explained. During the visit, Site Director Lauren Shaw arrived. At the time of inspection, the director and five staff members were supervising 26 children, and the facility was operating within the required staff-to-child ratio. The center operates Monday through Friday from 8:00 a.m. to 5:30 p.m. All staff present had criminal record clearances verified through the CDSS Guardian system.

LPA conducted a walkthrough of the facility to assess health and safety hazards. The physical plant was observed to be clean, well-maintained, and equipped with adequate heating, lighting, and ventilation. Classrooms contained appropriate toys, educational materials, and sturdy furniture in good repair. A carbon monoxide detector was present; however, staff reported that the battery had been low, causing the alarm to activate repeatedly when attempts were made to reinstall it. The device had been disconnected as a result. During the inspection, staff replaced the battery, and LPA verified that the carbon monoxide detector was restored to proper working conditions. The facility was also equipped with centralized smoke detectors, fully charged fire extinguishers, and functioning telephones. All hazardous materials, including cleaning solutions and chemicals, were stored out of children's reach. Sleeping cots were properly stored, and each child had an individual cubby for personal belongings. Emergency equipment was secure and accessible to staff.

The center uses Brightwheel for electronic sign-in and sign-out. A review of the system confirmed that parents used their individual PINs and that timestamps accurately reflected the number of children present.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 06/04/2026
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: ABC ACADEMY PRESCHOOL
FACILITY NUMBER: 210105818
VISIT DATE: 06/04/2026
NARRATIVE
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During the inspection of the kitchen area, LPA observed that the child-proof gate at the kitchen entry was missing. The lead teacher stated that the gate had broken approximately two weeks prior. While on site, staff repaired and reinstalled the child-proof gate. LPA verified that the gate was properly fixed and securely in place.

Children’s medications were stored in a centralized cabinet located in the off-limits kitchen area. Medications were observed to be stored in individual zip bags along with parental consent forms. LPA reminded the director that all medications must be kept in their original containers and must include physician instructions or medication-label directions to ensure proper administration. LPA also reminded the director that when a child disenrolls, medications must be returned to the parent or documented on the LIC 622 Centrally Stored Medication and Destruction Record.

Children’s restrooms were clean, sanitary, and in good working condition. A separate restroom for staff was available. No bodies of water were observed on the premises.

The outdoor play area was inspected and found to be clean, fully fenced, and free of hazards. The area contained various play structures, including slides, swings, playhouses, monkey bars, and sandboxes. Wood chips were present beneath climbing equipment to provide cushioning in the event of falls. Outdoor equipment was in good repair.

The director reported that the center provides morning and afternoon snacks. Children either bring lunch from home or purchase lunch on-site. Children bring their own water bottles, and the center provides water for refills. All solid-waste containers had tight-fitting lids.

Required postings were observed, including the facility license, Notification of Parent Rights, Personal Rights, Car Seat Law, Emergency Disaster Plan, waiver, and daily activity schedule. A review of children’s files showed complete records, including immunizations, admission agreements, emergency contact information, and personal rights forms. Personnel files reviewed contained current CPR certifications, mandated reporter training certificates, and documentation of required ECE units for the director and staff.

The director stated that fire and earthquake drills are conducted monthly. The most recent drill was completed on May 1, 2026, and properly logged and documented.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
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: ABC ACADEMY PRESCHOOL
FACILITY NUMBER: 210105818
VISIT DATE: 06/04/2026
NARRATIVE
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During the inspection, LPA obtained the following updated licensing documents: LIC 500, LIC 610, and LIC 308.

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.

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 COMPLETED TESTING AND NO LEAD EXCEEDANCES:

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

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02-CCP. 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) 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/.

The 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.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.


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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
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: ABC ACADEMY PRESCHOOL
FACILITY NUMBER: 210105818
VISIT DATE: 06/04/2026
NARRATIVE
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Pesticide regulations were discussed with the Site Director. In accordance with the Healthy Schools Act, California law requires that anyone using any pesticide must be trained every year in integrated pest management and the safe use of pesticides around children. The director was advised that a free one-hour online course is available on the Department of Pesticide Regulation's website: www.cdpr.ca.gov/schoolipm/training. For questions, email ccipmlist@cdpr.ca.gov.

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.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Lauren Shaw.

NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 06/04/2026
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/04/2026
LIC809 (FAS) - (06/04)
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