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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005558
Report Date: 09/28/2022
Date Signed: 09/28/2022 03:02:43 PM

Document Has Been Signed on 09/28/2022 03:02 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BRIGHT STARS CHILDREN'S CENTERFACILITY NUMBER:
214005558
ADMINISTRATOR:TALEBLOO, NAHIDFACILITY TYPE:
830
ADDRESS:199 GREENFIELDTELEPHONE:
(415) 310-7543
CITY:SAN RAFAELSTATE: CAZIP CODE:
94901
CAPACITY: 19TOTAL ENROLLED CHILDREN: 19CENSUS: 13DATE:
09/28/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
11:30 AM
MET WITH:Nahid Talebloo & Irma De LeonTIME COMPLETED:
01:30 PM
NARRATIVE
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On September 28, 2022, Licensing Program Analysts (LPA) Winnie Ly conducted an Unannounced Required - 1 Year inspection and met with Site Director Nahid Talebloo and Lead Teacher Irma De Leon. The purpose of the inspection was explained. There are 13 infants and toddler present today with 5 staff . Staff to child ratio is met today. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide (CO) detector. At least one staff have current Pediatric First Aid and CPR. Facility has posted all the required licensing forms in a prominent accessible location.

There are no bodies of water on the premises. Per staff, there are no firearms or weapons at the center. All cleaning supplies and toxins were locked or inaccessible to the children. All solid waste storage bins are secured with tight fitting lids. There is a variety of age appropriate toys and materials, including cribs. Napping equipment used in the center meets regulation requirements.

Changing tables are within arms reach of a sink. Parents provide all diapers/milk/formula and food. All bottles were labeled with the child's name and date. Parents wash/sterilize the bottles at home at the end of each day. LPA observed working smoke and carbon monoxide present on premises.

LPA and Site Director also toured the outdoor play area for Health and Safety Hazards. LPA observed outdoor equipment is in good condition, free from loose, sharp or pointed parts. Outdoor equipment appears to be age appropriate for children in care. Last Emergency Drill was conducted on 09/14/2022 and properly logged.

At approximately 12:00pm, a random sample of children's files were reviewed and found to have emergency identification information and medical assessments. In the children’s files, all have current immunization and a copy of Parent's Rights.

LPA also review staff files and found staff files are incomplete. Facility was provided with a list of Licensing Required documentation to be kept in staff files. Incomplete files poses a potential health and safety risk to children in care. Type B citation is being cited in accordance with the California Code of Regulations, Title 22, see LIC 809D.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE: DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/28/2022
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 09/28/2022 03:02 PM - It Cannot Be Edited


Created By: Winnie Ly On 09/28/2022 at 12:16 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 CHILDREN'S CENTER
FACILITY NUMBER: 214005558

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101217(d)
Personnel Records
(d) All personnel records shall be maintained at the child care center and shall be available to the licensing agency for review.

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 which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 10/10/2022
Plan of Correction
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Director will have staff completed all required licensing forms and email/send proof of completion to LPA by 10/10/2022.
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:Garfield Leung
LICENSING EVALUATOR NAME:Winnie Ly
LICENSING EVALUATOR SIGNATURE:
DATE: 09/28/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/28/2022


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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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: BRIGHT STARS CHILDREN'S CENTER
FACILITY NUMBER: 214005558
VISIT DATE: 09/28/2022
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Facility does not have children that need IMS at this time. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care 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

Facility was also informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. All staff have proof of Immunization.

LPA discussed Child Abuse Mandated Training AB1207 with the Director. As of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

Pesticide regulations were discussed with the Director. 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 director 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.

LPA discussed the safe sleep regulations with licensee and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee 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.

An exit interview was conducted and Plans of Corrections (POC) were developed and reviewed with Lead Teacher. A copy of this report and appeal rights were discussed and left with Lead Teacher whose signature on this form confirm receipt of these reports.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 09/28/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/28/2022
LIC809 (FAS) - (06/04)
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