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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 210108889
Report Date: 12/03/2024
Date Signed: 12/03/2024 12:32:05 PM

Document Has Been Signed on 12/03/2024 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:C.A.M.(CFS)-OLD GALLINAS CHILDREN'S CENTER (SA)FACILITY NUMBER:
210108889
ADMINISTRATOR/
DIRECTOR:		LEYDIS MATAFACILITY TYPE:
840
ADDRESS:251 NORTH SAN PEDRO ROADTELEPHONE:
(415) 479-2771
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 69TOTAL ENROLLED CHILDREN: 68CENSUS: 0DATE:
12/03/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:05 AM
MET WITH:Alexandra HallumTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
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On December 3, 2024, Licensing Program Analysts (LPAs) Van and Naves conducted an unannounced annual inspection and met with the new site director, Alexandra Hallum. The purpose of the inspection was explained, and access to the Center was granted. This facility is a school-aged after-school program. The Center approved using rooms #6, #7, and portable #26. The days and operation hours are Monday – Friday from 7:30 am – 5:30 pm. The Director stated that staff members pick up the children from school on Mondays, Tuesdays, Thursdays, and Fridays at 3:30 pm. However, on Wednesdays, the children are picked up earlier, with staff arriving at 1:30 pm. No children were present during the inspection.

The Director and LPAs inspected the facility for potential health and safety hazards. All classrooms are equipped with age-appropriate games, books, and well-maintained facilities. The rooms have good ventilation and ample lighting. The facility has a centralized smoke detector, fully charged fire extinguishers, and carbon monoxide detectors. The bathrooms are clean and well-sanitized; all solid waste bins have suitable tightly fitted lids. Cleaning products and disinfectants were observed and stored in the cabinet under the sinks with child-proof locks. During the inspection, the LPAs noticed that one of the unused electrical outlets was left uncovered. LPAs reminded the director that all unused electrical outlets should be adequately covered when not in use. Per the director, there are no guns or weapons on the premises. LPAs did not observe any pools or bodies of water on the premises.

The outdoor playground area is in good repair and completely fenced for supervision. The play structure is age-appropriate and in good condition. According to the director, the school-age program also shared the outdoors with the preschool program. LPA reminded the director the children in the two programs can not commingle.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/03/2024
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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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: C.A.M.(CFS)-OLD GALLINAS CHILDREN'S CENTER (SA)
FACILITY NUMBER: 210108889
VISIT DATE: 12/03/2024
NARRATIVE
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According to the director, the center’s staff picks up the children from school each day, which is just four blocks away. Some children arrive by school bus, which gets dropped off at a designated location, where teachers will pick them up. Once all the children are gathered, the teacher signs them in and conducts a headcount before they enter the classroom.

In today's inspection, LPA reviewed random samples of children's and staff records. All children had a medical assessment, and the required licensing forms were completed. All staff has criminal record clearance. All required posting. (i.e., License, waivers, Notification of Parent's Rights, and Notification of Personal Rights) were observed. The Director stated that Fire and Earthquake drills are conducted monthly, with the most recent drills completed on 11/14/2024.

The incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Childcare 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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The 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 a Childcare Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
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: C.A.M.(CFS)-OLD GALLINAS CHILDREN'S CENTER (SA)
FACILITY NUMBER: 210108889
VISIT DATE: 12/03/2024
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LPAs reminded the Director that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles.
The Director was informed about the Mandated Reporter training that is available on the CCLD website. In addition to AB1207 training, which must be completed every two years by 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

LPAs encouraged the Director to visit the CCLD website at www.ccld.ca.gov for licensing regulations and new updates. The Director can also email childcareadvocatesprogram@dss.ca.gov and ask for the updates to be added to the email list. 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:
LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process.

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

Exit interview conducted and report was reviewed with the site director, Alexandra Hallum.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 12/03/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/03/2024
LIC809 (FAS) - (06/04)
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