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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 380504052
Report Date: 11/03/2025
Date Signed: 11/03/2025 12:27:32 PM

Document Has Been Signed on 11/03/2025 12:27 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/
DIRECTOR:		ADE LAURELFACILITY TYPE:
850
ADDRESS:2340 -42ND AVENUETELEPHONE:
(628) 899-8067
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94116
CAPACITY: 49TOTAL ENROLLED CHILDREN: 43CENSUS: 26DATE:
11/03/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:33 AM
MET WITH:Laurel AdeTIME VISIT/
INSPECTION COMPLETED:
12:45 PM
NARRATIVE
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On November 3, 2025, Licensing Program Analyst (LPA) Van conducted an unannounced annual random inspection. The purpose of the inspection was explained, and access to the Center was granted. This is a preschool parent-cooperative center. Five teachers, the Director, and six cooperative parents supervised 26 preschool children during the visit. The facility complies with the staff-children ratios today.

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

Along with the director, LPA inspected the physical plant to identify any potential health and safety hazards. The classrooms are well-maintained and have proper temperature control and ventilation. Age-appropriate toys and learning materials are available in all classrooms. The furniture was observed to be sturdy and in good condition. Additionally, the center has multiple combinations of smoke and carbon monoxide detectors, as well as several fully charged fire extinguishers rated at 2A:10BC.

LPA observed that each child has their own cubby labeled with their name. All emergency supplies are stored in a locked storage area. Medications are stored in a central box in the Director’s office bathroom. LPA reminded the director to ensure all medications are kept in their original containers, with parental consent and the doctor’s directive. First aid supplies are fully stocked and ready for children's use.

The center has a manual sign-in and sign-out binder located in front, just behind the main entrance. Upon reviewing the records, it was found that not all parents' names were properly printed, and some parents did not sign their names or signed in the printed section, while the signature section was left blank.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE: DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/03/2025
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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Document Has Been Signed on 11/03/2025 12:27 PM - It Cannot Be Edited


Created By: Brendon Van On 11/03/2025 at 11:58 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: 11/03/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.7995(a)(1)
General Provisions and Definitions
(1) Commencing September 1, 2016, a person shall not be employed or volunteer at a day care center if he or she has not been immunized against influenza, pertussis, and measles. Each employee and volunteer shall receive an influenza vaccination between August 1 and December 1 of each year.

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 section cited above. One out of six staff members did not have complete immunization records on file or available for review; this includes measles, which poses a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 12/03/2025
Plan of Correction
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Before commencing employment, the center/director must ensure that all staff members' immunization records are complete and on file. The director will obtain the immunization records of a staff member and include them in the personnel file by the due date of 12/3/2025. A follow-up visit will be conducted to confirm that any deficiencies have been addressed.
Type B
Section Cited
CCR
101216(g)(1)
Personnel Requirements
(1) Except as specified in (3) below, good physical health shall be verified by a health screening, including a test for tuberculosis, performed by or under the supervision of a physician not more than one year prior to or seven days after employment or licensure.

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 section cited above. Two out of six teachers did not have their Health Screening LIC 503 completed by their physician, or their documentation was missing from their files, which poses a potential risk to the health, safety, or personal rights of children in care.
POC Due Date: 12/03/2025
Plan of Correction
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The center/director must ensure that all staff members have the Health Screening form LIC 503 completed by their physician, no more than 1 year prior to or within 7 days after employment. These forms must be included in the personnel file by the deadline of 12/3/2025. A follow-up visit will be conducted to verify that any deficiencies have been addressed.
Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
Garfield Leung
NAME OF LICENSING PROGRAM MANAGER:
Brendon Van
NAME OF LICENSING PROGRAM ANALYST:
LICENSING PROGRAM ANALYST SIGNATURE:
DATE: 11/03/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/03/2025


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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052
VISIT DATE: 11/03/2025
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All cleaning solutions, poisons, and other hazardous chemicals are stored in an area inaccessible to children. The sleeping cots are appropriately stored. All children's toilets and handwashing sinks are in good working order and are properly sanitized. There is a separate staff bathroom on the premises. LPA observed no bodies of water on the premises.

The kitchen, food preparation, and storage areas were inspected and found to be clean and free of litter and rubbish. All food was observed to be protected against contamination. All solid waste storage containers have tight-fitting lids.

According to the director, the co-op parent rotates every four weeks to prepare snacks for children. Snacks are made on site. Children bring their lunch from home. The facility has a water filtration pitcher and paper cups for children indoors and outdoors.

The outdoor play area is kept clean and free of debris. It is also completely fenced, clean, and in good repair. All play structures were observed to be in good working condition. The director stated sandboxes are inspected daily before children use them. LPA reminded the Director that drinking water should be available and freely accessible.

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. 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. All staff members have valid CPR certifications and have up-to-date mandated reporter training certificates. However, 1 in 6 teachers lacked a complete immunization record, with the Measles (MMR) missing, and 2 of the 6 teachers had their Health Screening LIC 503 either completed by their physician or missing from their file. As a result, deficiencies were issued today.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052
VISIT DATE: 11/03/2025
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The Director stated that the Center conducts fire and earthquake drills at least once every six months; the last drills were conducted on 5/15/2025.

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 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:

LPA 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/.

The Director 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.
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NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
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: PLAYMATES COOPERATIVE NURSERY SCHOOL
FACILITY NUMBER: 380504052
VISIT DATE: 11/03/2025
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LPA discussed AB1207, the Child Abuse Mandated Training, with the Director. 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 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.

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 Director, Laurel Ade.
NAME OF LICENSING PROGRAM MANAGER: Garfield Leung
NAME OF LICENSING PROGRAM ANALYST: Brendon Van
LICENSING PROGRAM ANALYST SIGNATURE:

DATE: 11/03/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/03/2025
LIC809 (FAS) - (06/04)
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