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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005538
Report Date: 12/04/2025
Date Signed: 12/04/2025 11:52:06 AM

Document Has Been Signed on 12/04/2025 11:52 AM - 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) MANZANITAFACILITY NUMBER:
214005538
ADMINISTRATOR/
DIRECTOR:		SHELLEY EHRETFACILITY TYPE:
850
ADDRESS:630 DRAKE AVENUE, PORTABLE CTELEPHONE:
(415) 526-7500
CITY:SAUSALITOSTATE: CAZIP CODE:
94965
CAPACITY: 20TOTAL ENROLLED CHILDREN: 10CENSUS: 9DATE:
12/04/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:04 AM
MET WITH:Sanaa MehtarTIME VISIT/
INSPECTION COMPLETED:
12:10 PM
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On December 4, 2025, Licensing Program Analysts (LPAs) Van and Leong conducted an unannounced annual inspection. The purpose of the inspection was explained to the new site supervisor, Sanaa Mehtar, and the site supervisor granted LPAs access to the center. This is a preschool program that operates only in Portable C. Upon entering the classroom, LPAs observed the site supervisor and a teacher supervising five preschool children. During the visit, four more children arrived, bringing the total to nine children. The facility complied with staff-children ratios.

All staff members' criminal record clearances were verified through the CDSS Guardian Background Check system, and their status indicated they were cleared as eligible.

According to the site supervisor, she has been in that role since 2024. However, the department has not yet received any site supervisor qualification requirements. During the visit, LPAs provided the site supervisor with the checklist and instructed her to submit the packet by December 19, 2025. LPAs also reviewed the reporting requirements with her and informed her that the center must report any change in the child care center director or designee(s) to the Department within 10 days.

LPAs inspected the physical plant to identify any potential health and safety hazards. The program operates in a large open floor with shelves used as partitions for each activity space. The space is well-maintained and has proper temperature control and ventilation. Age-appropriate toys and learning materials are available. The furniture was observed to be sturdy and in good condition. Additionally, the center has multiple combinations of smoke and carbon monoxide detectors, and several fully charged 2A:10BC fire extinguishers.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 12/04/2025
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: C.A.M. (CFS) MANZANITA
FACILITY NUMBER: 214005538
VISIT DATE: 12/04/2025
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LPAs observed that each child has their own cubby labeled with their name. All emergency supplies are stored in a locked storage area. Children's medication was stored in the high cabinet within off-limits areas, making it inaccessible to children. All medications were kept in their original containers, and with parental consent. First aid supplies are fully stocked and ready for children's use.

It was observed that two outlets were in use, and electrical wires were dangling next to the light box table. LPAs informed the site supervisor to install covered wires and an outlet cover box to prevent children from pulling on them and potentially exposing the outlet, which would pose a health and safety risk to children. During the visit, the site supervisor unplugged the devices from the outlets and covered the outlets until the building maintenance staff could address the issue. The site supervisor will send pictures of the covered once the maintenance team installs them.

The center uses a manual sign-in and sign-out. After reviewing the records, it was found that the parent signed with their complete signature, and the count matched the number of children present.

All cleaning solutions, poisons, and other hazardous chemicals are stored in an area inaccessible to children. All children's toilets and handwashing stations are in good working order and are properly sanitized. There is a separate staff bathroom on the premises. LPAs observed no bodies of water on the premises. The sleeping cots are appropriately stored.

According to the site supervisor, the center provides breakfast, lunch, and snacks in the AM and PM. All foods are prepared in C.A.M.'s central kitchen. The center offers water bottles and has a water filtration pitcher available for children to refill. All solid waste storage containers have tight-fitting lids.

The facility has a playground waiver approved, allowing the use of Rocky Graham Park (850 Drake Ave, Sausalito) as an outdoor space. The outdoor play area is fully fenced, clean, and well-maintained. Outdoor play structures are in good condition, free of loose parts, and have soft cushioning underneath to absorb falls. The LPA reminded the Site supervisor that staff must ensure the playground is free of debris or harmful materials before use and that children have access to drinking water. Additionally, staff must follow the ratio of one teacher to six children when supervising on the playground.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
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) MANZANITA
FACILITY NUMBER: 214005538
VISIT DATE: 12/04/2025
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All required postings, such as the facility License, Notification of Parent Rights, Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities, were posted.

Random children's records and personnel records were reviewed during the inspection. The center stores children’s records electronically. Records reviews showed that the facility has complete records for each child, including immunizations, admission agreements, emergency contact information, and personal rights.

Staff records indicate that all staff or other individuals who require caregiver background checks have received criminal records and child abuse index clearances or exemptions. The site supervisor has a valid CPR certification. All staff maintain proper immunization records and have mandated reporter training certificates.

The Site supervisor 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 Childcare 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 Childcare 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 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/.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC809 (FAS) - (06/04)
Page: 4 of 5
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) MANZANITA
FACILITY NUMBER: 214005538
VISIT DATE: 12/04/2025
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The Site supervisor was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain childcare by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

LPAS discussed AB1207, the Child Abuse Mandated Training, with the Site supervisor. 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.

Pesticide regulations were discussed with the Site supervisor. 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 site supervisor was advised that a free one-hour online course is available on the Department of Pesticide Regulation's Web site: 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 the report was reviewed with the site supervisor, Sanaa Mehtar.
NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 12/04/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/04/2025
LIC809 (FAS) - (06/04)
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