213005156-12-1-2023-05-CC-HLEG-CY52EU-20231201162032

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213005156
Report Date: 12/01/2023
Date Signed: 12/01/2023 04:20:44 PM

Document Has Been Signed on 12/01/2023 04:20 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:	NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL		FACILITY NUMBER:	213005156
ADMINISTRATOR:	FLETCHER, NICOLE		FACILITY TYPE:	850
ADDRESS:	360 NOVA ALBION WAY		TELEPHONE:	(415) 479-8980
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 36	DATE:	12/01/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	01:40 PM
MET WITH:	Nicole Fletcher		TIME COMPLETED:	04:30 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 12/1/2023, Licensing Program Analysts (LPAs) Hanson Leong and Janet Gil, made an unannounced required visit to the child daycare facility listed above. The LPAs were granted entry by the Director, Nicole Fletcher. The LPAs explained the purpose of the visit to Ms. Fletcher. Present in the facility: 5 staff members, and 36 preschool aged children. All individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. The facility is operating within its capacity and in accordance with the required ratio of staff to children. Hours of operation: Mon-Fri, 8:00 am- 5:00 pm. The LPAs and Ms. Fletcher both performed comprehensive inspections of the facility to look for possible threats to health and safety. The LPAs observed that the facility maintains a paper record of when children sign in and out, and the number of parent signatures did match the number of children enrolled for the day. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPAs observed that the playground equipment and outdoor furnishings are in very good shape. The LPAs found three fish tanks that have been safely safeguarded from the children. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order. According to Ms. Fletcher, the facility does not house any firearms or other types of weapons. The LPAs observed a designated area for children to sleep or rest quietly. The area has sufficient sleeping mats for each child, and all mattresses and bedding are stored in the appropriate location. The facility has one designated changing table with at least one inch of cushioning and disposable paper coverings. The LPAs reminded Ms. Fletcher that emergency exits must always remain clear, and that sleeping mats cannot be situated in a manner that blocks emergency exits. See Page 2

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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 12/01/2023 04:20 PM - It Cannot Be Edited

Created By: Hanson Leong On 12/01/2023 at 03:36 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL	FACILITY NUMBER: 213005156
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/01/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

(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 interview and record review, the licensee did not comply with the section cited above, which poses a potential health, safety or personal rights risk to children in care.
	POC Due Date: 01/01/2024
	Plan of Correction
1 2 3 4	Lead water results and supporting documents must be submitted to the department by the above due date.

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:

Daniel J Oquendo

LICENSING EVALUATOR NAME:

Hanson Leong

LICENSING EVALUATOR SIGNATURE:

DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL	FACILITY NUMBER: 213005156
	VISIT DATE: 12/01/2023

NARRATIVE

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The LPAs observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities)

The LPAs reviewed both the children's and staff records. The LPAs reviewed the 5 children's records and found that all 5 children have a record of their emergency information on file The LPAs reviewed the records of the 5 staff members and found that the 5 staff members possess a valid certification in Pediatric First Aid/CPR and Mandated Reporter. The LPAs also found that all 5 staff members possess the required 12 Early Childhood Education (ECE) units, which are necessary qualifications for being a qualified teacher.

The LPAs reviewed the facility's emergency drill log. According to the facility's emergency drill log, the last fire, earthquake and lockdown drill were carried out on 08/23/2023.

Ms. Fletcher 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.

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).

LPAs verified that the lead testing was not completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. (Refer to LIC 809D for citation)

See Page 3

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

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: NOVATO ENRICHMENT CARE-MISS NICKY'S PRESCHOOL	FACILITY NUMBER: 213005156
	VISIT DATE: 12/01/2023

NARRATIVE

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LPAs referred Ms. Fletcher to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPAs discussed the safe sleep regulations with Ms. Fletcher 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. LPAs also informed Ms. Fletcher 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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. 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-carecenters/. IF THERE IS NO

Ms. Fletcher 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.

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.

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 copy of today’s report and the facility’s appeal rights were given to Nicole Fletcher. A Notice of Site Visit was given to Nicole Fletcher and must remain posted on, or immediately adjacent to, the interior side of the main door for 30 days. Exit interview conducted and

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:	DATE: 12/01/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/01/2023

LIC809 (FAS) - (06/04)

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