<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213006108
Report Date: 07/01/2024
Date Signed: 07/01/2024 12:23:28 PM

Document Has Been Signed on 07/01/2024 12:23 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) SAN PEDRO (PS)FACILITY NUMBER:
213006108
ADMINISTRATOR/
DIRECTOR:
LOMBARDI, KELSEYFACILITY TYPE:
850
ADDRESS:498 POINT SAN PEDRO ROADTELEPHONE:
(415) 485-2450
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 40TOTAL ENROLLED CHILDREN: 12CENSUS: 10DATE:
07/01/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:20 AM
MET WITH:Sheila VicenteTIME VISIT/
INSPECTION COMPLETED:
12:35 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 7/1/2024, Licensing Program Analyst (LPA) Hanson Leong conducted an unannounced annual visit to the Child Care Center (CCC) listed above. LPA met with the Preschool Teacher, Sheila Vicente, and explained the purpose of the visit. Ten preschool-aged children and three staff members were present during the visit. The three staff members present at the CCC received criminal record clearance from the department. The CCC is within its capacity limits and ratio. The director was not present during today's visit.

LPA observed that all required documents, such as the facility license, waivers, parental and personal rights notifications, car seat laws, emergency disaster plan, and daily activities schedule, were displayed in a prominent, publicly accessible location.

The most recent emergency disaster drill took place on 6/21/2024, and the LPA observed that it was properly documented. LPA reviewed the emergency disaster drill log and found that they were conducted every one to two months.

LPA conducted an inspection for potential health and safety hazards and found the center’s interior to be clean, safe, and well-maintained. According to Ms. Vicente, the facility provides food and snacks for the children from an outside vendor. LPA reminded Ms. Vicente about the importance of sanitation and proper food preparation. Snacks were observed to be available for the children. Prescribed medications were observed to be properly stored in a cabinet and labeled according to the child's name. The CCC was observed to have a first aid kit, functioning smoke and carbon monoxide detectors, and a fully charged fire extinguisher.

See Page 2

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE: DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/01/2024
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: C.A.M. (CFS) SAN PEDRO (PS)
FACILITY NUMBER: 213006108
VISIT DATE: 07/01/2024
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
26
27
28
29
30
31
32
Page 2

LPA observed that Classroom A was equipped with age-appropriate toys, furniture, and educational materials, and each child had their own designated storage space. Electrical outlets were observed to be properly covered. A step stool for the sink was available for the children. According to Ms. Vicente, the second classroom, Classroom B, is not being used until the new school year begins. The second classroom was observed to be used as a storage room.

The bathroom was found to be clean and fully operational. The toilets and handwashing facilities were well-kept, safe, and clean.

All accessible cabinets and drawers in the classrooms were found to be free of hazardous materials or poisons. Disinfectants, cleaning solutions, poisons, and other items that could pose a danger were stored in the cabinets with child safety locks and were inaccessible to the children.

The outdoor playground was enclosed by a fence, and the play equipment was well-maintained. The areas around and under high climbing equipment, swings, slides, and other similar equipment were observed to be cushioned with material that absorbs falls. No bodies of water, such as pools or spas, were present on site.

The sleeping/resting area was observed to be clean and sanitary. Sleeping mats, blankets, and sheets are available for children to use.

LPA observed that the CCC currently records the child's attendance manually on paper. The paper accounts for all parent signatures for each child. LPA reviewed five children’s files and confirmed that all five children have complete files that include their emergency contact and medical information.

LPA reviewed the files for three staff members and confirmed that all three were up to date with their Pediatric First Aid/CPR certifications. LPA found that two of the three staff members had completed the necessary twelve units in Early Childhood Education (ECE), which meet the qualifications required to be classified as a preschool teacher. The third staff member is employed as a teacher’s assistant.

See Page 3

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
LIC809 (FAS) - (06/04)
Page: 2 of 4
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) SAN PEDRO (PS)
FACILITY NUMBER: 213006108
VISIT DATE: 07/01/2024
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
26
27
28
29
30
31
32
Page 3

LPA reminded Ms. Vicente that each staff file must contain their immunization records. LPA requested that Ms. Vicente email the staff’s immunization records to the department to ensure compliance. The facility was given a technical violation for not having the staff’s immunization records on file.

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.

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

Facility Representative 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.

LPA discussed the safe sleep regulations with facility representative 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. LPA also informed facility representative 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:

See Page 4

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: C.A.M. (CFS) SAN PEDRO (PS)
FACILITY NUMBER: 213006108
VISIT DATE: 07/01/2024
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
26
27
28
29
30
31
32
Page 4
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/.

Facility Representative 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.

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

No deficiencies were issued today during LPA's visit.

A copy of today’s report was given to the Preschool Teacher, Sheila Vicente. A Notice of Site Visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Preschool Teacher, Sheila Vicente.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Hanson Leong
LICENSING EVALUATOR SIGNATURE:

DATE: 07/01/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/01/2024
LIC809 (FAS) - (06/04)
Page: 4 of 4