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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005301
Report Date: 12/09/2024
Date Signed: 12/09/2024 02:00:05 PM

Document Has Been Signed on 12/09/2024 02:00 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:BRIGHT STARS INFANT CENTERFACILITY NUMBER:
214005301
ADMINISTRATOR/
DIRECTOR:		NAHID TALEBLOOFACILITY TYPE:
830
ADDRESS:1055 LAS OVEJAS AVENUETELEPHONE:
(415) 310-7543
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY: 35TOTAL ENROLLED CHILDREN: 9CENSUS: 6DATE:
12/09/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:55 AM
MET WITH:Teacher, Matilde ArevaloTIME VISIT/
INSPECTION COMPLETED:
02:15 PM
NARRATIVE
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On 12/9/2024, at approximately 9:55AM, Licensing Program Analyst (LPA) Jonathan Tse conducted an unannounced annual visit at the facility. LPA met with Teacher Matilde Arevalo (S1) and explained the purpose of the visit. Present during the visit was S1, two staff members, and six infants. The facility is operating within staffing and ratio requirements on this day. The facility’s operating hours are from 7:30AM to 5:00PM, Monday to Friday.

The facility is a combination center, located on the same premises as facility 214005394. This facility is licensed to operate in Rooms 7 and 8. LPA and S1 inspected the facility for any health or safety hazards. There are fully charged fire extinguishers that are at least size 2A10BC. LPA observed a fire alarm system running throughout the facility. LPA observed that there were no carbon monoxide detectors present in either infant room. S1 stated that the carbon monoxide detectors were having their batteries replaced. LPA informed S1 that a deficiency would be issued due to the facility not having any carbon monoxide detectors present. Electrical outlets were observed to be covered or blocked when not in use to be inaccessible to children in care. Poisons, cleaning detergents, and other chemicals are stored inaccessible. There are temperature and ventilation controls for the comfort and safety of children in care.

LPA observed there to be age-appropriate toys and learning materials present. Furniture was observed to be age-appropriate and free of rough or sharp edges. The surface of the indoor activity space was observed to be free of debris and other loose articles. There are cubbies available for each child’s belongings. There are refrigerators present in both classrooms for storage of children’s meals and milk. LPA advised that containers shall be labeled so that children’s meals are not mixed up. S1 stated that they understood. LPA advised that snacks shall be offered for children in case they do not bring additional snacks from home.


Continued on Page Two
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/09/2024
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 10
Document Has Been Signed on 12/09/2024 02:00 PM - It Cannot Be Edited


Created By: Jonathan Tse On 12/09/2024 at 01:09 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: BRIGHT STARS INFANT CENTER
FACILITY NUMBER: 214005301

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above by having a staff member without a criminal record clearance present which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 12/10/2024
Plan of Correction
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Licensee shall have S3 fingerprinted and associated to the facility. S3 shall not return to the facility until they have acquired fingerprint clearance. Licensee shall provide LPA with a copy of the LiveScan receipt via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Ali Zebila
LICENSING EVALUATOR NAME:Jonathan Tse
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2024


LIC809 (FAS) - (06/04)
Page: 2 of 10
Document Has Been Signed on 12/09/2024 02:00 PM - It Cannot Be Edited


Created By: Jonathan Tse On 12/09/2024 at 01:09 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: BRIGHT STARS INFANT CENTER
FACILITY NUMBER: 214005301

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on observation and interview, the licensee did not comply with the section cited above by not maintaining operational carbon monoxide detectors at the facility, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/06/2025
Plan of Correction
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Licensee shall install replace the carbon monoxide detectors in each classroom and send photos of the detectors to LPA via email.
Type B
Section Cited
CCR
101416.2(d)
Infant Care Teacher Qualifications and Duties
(d) A photocopy of each teacher's transcript(s) documenting successful completion of required course work shall be maintained at the center.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in [two out of three staff files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/06/2025
Plan of Correction
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Licensee shall obtain transcripts (official or unofficial) for all staff members and maintain them in the personnel files. Transcripts must show completed or currently enrolled ECE courses. Licensee shall provide copies of transcripts to LPA via email.
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:Ali Zebila
LICENSING EVALUATOR NAME:Jonathan Tse
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2024


LIC809 (FAS) - (06/04)
Page: 3 of 10
Document Has Been Signed on 12/09/2024 02:00 PM - It Cannot Be Edited


Created By: Jonathan Tse On 12/09/2024 at 01:09 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: BRIGHT STARS INFANT CENTER
FACILITY NUMBER: 214005301

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 12/09/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101220(a)
Child's Medical Assessments
(a) Prior to, or within 30 calendar days following the enrollment of a child, the licensee shall obtain a written medical assessment of the child. This medical assessment enables the licensee to assess whether the center can provide necessary health-related services to the child.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above in two out of five children's files which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 01/06/2025
Plan of Correction
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Licensee shall provide LPA with copies of signed Physician's Reports (LIC701) for C3 and C4 via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Ali Zebila
LICENSING EVALUATOR NAME:Jonathan Tse
LICENSING EVALUATOR SIGNATURE:
DATE: 12/09/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 12/09/2024


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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: BRIGHT STARS INFANT CENTER
FACILITY NUMBER: 214005301
VISIT DATE: 12/09/2024
NARRATIVE
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Children nap in cribs or on mats that are provided by the facility. LPA observed cribs to be functional and in good repair. There are mattresses that are fitted with tight-fitting sheets. S1 stated that the facility does not use sleep sacks or blankets for napping infants. There are infant swings present in the facility. LPA advised that manufacturer instructions are followed and that infants who fall asleep are immediately placed in a crib. S1 stated that they understood.

LPA observed the outdoor play areas to contain age-appropriate toys and equipment. The outdoor play area is cushioned with resilient padding. Per S1, one of the outdoor play areas is currently not in use. LPA advised that although the play area is not in use, it should still be maintained and kept free of debris and other loose materials. S1 stated that they understood. There is a sandbox present that per S1, is checked daily. The outdoor play area is enclosed by a fence that is at least four feet high. There are no swimming pools or other similar bodies of water present.

LPA reviewed three staff files, five children’s files, and facility records. There is at least one staff member present with current Pediatric First Aid/CPR training present. LPA advised that Mandated Reporter Training consists of two parts: General Training and Child Care Providers training. Staff have immunization records available for review. LPA observed that two out of three staff members did not have health screening reports (LIC503) or transcripts showing proof of completion or enrollment in Early Childhood Education courses present in their files. Upon review of the facility’s Guardian profile, LPA observed that one staff member, S3, did not have a criminal background clearance. LPA informed S1 that a Type A deficiency would be cited and a civil penalty of $100 would be assessed.

LPA observed children’s files to contain Emergency Identification and Information (LIC700) and Consent for Emergency Medical Treatment (LIC627). Infant Needs and Services Plans were made available for review during the visit. Infant sleeping logs are to be maintained and checked every 15 minutes. LPA advised that sleep logs can be maintained either digitally or on paper. LPA advised that updated Infant Needs and Services Plans shall be signed by both authorized representatives and the facility. LPA advised that children’s immunization records shall be kept up-to-date and maintained at the facility. LPA observed that two children’s files did not contain a completed and signed medical assessment. LPA informed S1 that a deficiency would be cited.

Continued on Page Three
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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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: BRIGHT STARS INFANT CENTER
FACILITY NUMBER: 214005301
VISIT DATE: 12/09/2024
NARRATIVE
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LPA observed required postings to be posted and accessible for review. The facility last conducted an emergency drill in August. Emergency drill logs were made available for review during the visit. Children are signed in and out of the facility via the Brightwheel app.

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.

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.

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).

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

LPA discussed the safe sleep regulations with the 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 licensee 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.
Continued on Page Four
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BRIGHT STARS INFANT CENTER
FACILITY NUMBER: 214005301
VISIT DATE: 12/09/2024
NARRATIVE
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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-care-centers/.

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.

See LIC809-D for deficiencies cited today regarding criminal record clearance, carbon monoxide detectors, proof of completion of educational requirements for staff, and medical assessment forms for children. See LIC9102-TV for technical violations issued today regarding health screening reports, Mandated Reporter Training, and immunization records for children. Appeal rights were provided and explained. A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the facility representative Matilde Arevalo.

LPA Tse informed facility representative Matilde Arevalo that this report dated 12/9/2024 documents one Type A citation which shall be posted for 30 consecutive days as there is immediate risk to the health, safety, or personal rights of children in care.

Also, LPA Tse informed the facility representative to provide a copy of this licensing report dated 12/9/2024 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 12/09/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/09/2024
LIC809 (FAS) - (06/04)
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