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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504052
Report Date: 11/02/2023
Date Signed: 11/02/2023 12:19:27 PM

Document Has Been Signed on 11/02/2023 12:19 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:PLAYMATES COOPERATIVE NURSERY SCHOOLFACILITY NUMBER:
380504052
ADMINISTRATOR:AL-SARDI,(SCHULZE) SUMERFACILITY TYPE:
850
ADDRESS:2340 -42ND AVENUETELEPHONE:
(415) 681-2025
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 49TOTAL ENROLLED CHILDREN: 49CENSUS: 36DATE:
11/02/2023
TYPE OF VISIT:Required - 3 YearUNANNOUNCEDTIME BEGAN:
09:10 AM
MET WITH:SumER Al-SardiTIME COMPLETED:
12:45 PM
NARRATIVE
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On November 2, 2023, Licensing Program Analyst (LPA) Van met with Director Sumer Al-Sardi for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. The Center is a co-op preschool program. LPA observed five teachers, including the director and three co-op parents, supervising thirty-six children. All staff members have criminal clearance on file. The days and operations hours are Monday - Friday from 8:00 a.m. to 6:00 p.m.

The Director and LPA thoroughly examined the physical facility to identify potential health and safety hazards. The facility has a manual sign-in/out record system, and upon review, it showed that all parents' signatures matched and accounted for the number of children present. The facility is in good condition, and the temperature and ventilation levels are adequately maintained. Age-appropriate toys and educational materials are available in each classroom. The furniture is sturdy and well-maintained. LPA observed that each child has their own cubby available with their name labeled. The facility has multiple combinations of carbon monoxide and smoke detectors, fully charged fire extinguishers, and functioning telephones. LPA noticed that emergency supplies are securely stored, and first aid supplies are fully stocked and readily accessible to children. All hazardous materials, including cleaning solutions and poisons, are kept out of the reach of children. Sleeping cots are appropriately stored. Children's medications are securely kept. The toilets and handwashing sinks are in good working condition. LPA observed no bodies of water on the premises.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/02/2023
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 11/02/2023 12:19 PM - It Cannot Be Edited


Created By: Brendon Van On 11/02/2023 at 11:23 AM
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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1597.16(a)(1)
Lead Testing
(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
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Based on interviews and record reviews, it was revealed that the center did not comply with the above section. Specifically, the center failed to conduct lead testing of its water used for consumption before the January 1, 2023 deadline. Failing to complete the drinking water test for lead contamination levels could pose potential health and safety risks to the children in care.
POC Due Date: 12/02/2023
Plan of Correction
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The Director will contact the Certified Water Sampler to schedule a test of water fixtures used for water consumption for lead levels. A completed LIC9275, LIC9276, LIC999, and results of lead levels will be submitted to the Licensing office no later than the Plan of Correction (POC) due date.
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the interview and record review, the Center did not comply with the section cited above, as the Center does not have proof that fire drills are being conducted and documented at least once every six months. Which poses/posed a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 12/02/2023
Plan of Correction
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The Center must ensure that Fire and Earthquake drills are conducted at least once every six months and document the drills. The Center will provide LPA evidence of a completed emergency disaster drill no later than December 2, 2023. A return visit is necessary to verify the correction has been made.
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:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2023


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Document Has Been Signed on 11/02/2023 12:19 PM - It Cannot Be Edited


Created By: Brendon Van On 11/02/2023 at 11:23 AM
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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/02/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.8662(b)(1)
Administration of Child Day Care Licensing
(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on the record review, the Center did not comply with the abovementioned section. S1 have not completed their Mandated reporter training, which poses/posed a potential health, safety, or personal rights risk to persons in care.
POC Due Date: 12/02/2023
Plan of Correction
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The Center/Site Supervisor is responsible for ensuring that all staff complete the Mandated Reporter Training every two years. The record of completion should be available for inspection. The Director has stated that the S2 will complete the training by December 2, 2023.
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:Brendon Van
LICENSING EVALUATOR SIGNATURE:
DATE: 11/02/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/02/2023


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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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052
VISIT DATE: 11/02/2023
NARRATIVE
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The playground is securely fenced. The play structures are sturdy and free of loose parts. Additionally, soft cushioning material is placed beneath the play structures to minimize the chances of injuries from accidental falls. The director stated sandboxes are inspected daily before children use them. LPA reminded the Director to remove all water hoses after use to prevent tripping hazards.

During the inspection, LPA reviewed records pertaining to children and personnel. The record for each child was found to be complete, including their names, addresses, and authorized representative telephone numbers. Additionally, each child's file contains information about their immunization record, and medical assessment. Staff members' records showed that all individuals requiring caregiver background checks had undergone criminal records and child abuse index clearances or exemptions. Furthermore, several staff members possess valid CPR certificates, and all staff maintain up-to-date immunization records. However, a few staff members did not have the mandated reporter training completed or available for review during the visit. The director stated fire and earthquake drills were conducted sometime in May, but no documentation of the drills was maintained.

The facility had posted the required forms, including a License, Notification of Parent's Rights, Emergency Disaster Plan, and Daily activities. However, the Car seat law and Notification of Personal Rights were not posted. During the inspection, the Director printed and posted them. Per the Director, the Center does not provide food. All foods are brought to the Center by families. The children bring their water bottles from home, or the facility also has water readily available for refill for children indoors and outdoors. All storage containers for solid waste within the Center have a proper tight-fitting cover.

The Director 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.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023
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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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052
VISIT DATE: 11/02/2023
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/.

The Director was informed about Mandated Reporter training AB 1207. The Mandated Reporter AB 1207 training must be completed every two years by the Licensee and for all staff hired. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

The Director was informed of the MyChildCarePlan.org website, a consumer education website that helps families obtain child care by connecting them to childcare providers and Resource and Referral Agencies (R&Rs) throughout California.

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).

CCC DID NOT COMPLETE TESTING PRIOR TO THEIR DEADLINE,

LPA referred the Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023
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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052
VISIT DATE: 11/02/2023
NARRATIVE
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During the inspection, LPA requested the following updated document be sent to the Licensing office by December 2, 2023, to complete the annual inspection.

1. An up-to-date Emergency Disaster Plan (LIC 610)
2. Personnel Report (LIC 500)
3. Designation of Administrative Responsibility (LIC 308)
4. Basic Pest Management Training completion for all staff

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

See LIC809D for deficiency cited.

A notice of site visit was given and must remain posted for 30 days.

An exit interview was conducted, and the report and appeal rights were reviewed with the Director, Sumer Al-Sardi.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 11/02/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/02/2023
LIC809 (FAS) - (06/04)
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