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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384002242
Report Date: 10/18/2024
Date Signed: 10/18/2024 03:32:51 PM

Document Has Been Signed on 10/18/2024 03:32 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:CCFC-VV LELAND CENTER (P)FACILITY NUMBER:
384002242
ADMINISTRATOR/
DIRECTOR:		THERESA ILARINAFACILITY TYPE:
850
ADDRESS:325 LELAND AVENUETELEPHONE:
(415) 921-7019
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94134
CAPACITY: 88TOTAL ENROLLED CHILDREN: 88CENSUS: 45DATE:
10/18/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:30 AM
MET WITH:Ericka CruzTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
NARRATIVE
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On October 18, 2024 at approximately 9:30am, Licensing Program Analyst (LPA) Ly conducted an Unannounced Annual Visit and met with Site Supervisor, Ericka Cruz during the visit. Purpose of the inspection was explained. There were 10 staff including the Site Supervisor caring for 45 children. Teacher to child ratios were met on this day. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide detector. The center uses clipboards for parents to sign their children in and out of the program. Facility has posted all the required licensing forms in a prominent visible location.

LPA and Site Supervisor inspected the center for Health and Safety Hazards. There are no pools, spas or other bodies of water on the premises. Adequate first aid supplies are available. All cleaning supplies and other potentially harmful items are stored inaccessible to the children. Furniture and equipment are in good condition, free from loose, sharp or pointed parts. Children's bathrooms are in working order with adequate supplies. There are separate bathrooms on site for adults. The food preparation area is clean and orderly. The center provides breakfast, lunch ad snacks to the children and has a vendor lunch. Facility does not cook on site. Food is delivered from another facility. All solid waste storage containers have tight fitting lids. Drinking water is provided indoor and outdoor by disposable cups.

Medications are stored in cabinet inaccessible to children. LPA reviewed medication procedures with staff. During review of medication, LPA observed an Epinephrine belongs to current enrolled child has been expired since August 2024. Expired medication poses a potential health and safety risk to children in care. Type B citation has been issued on this day 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: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/18/2024
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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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: CCFC-VV LELAND CENTER (P)
FACILITY NUMBER: 384002242
VISIT DATE: 10/18/2024
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LPA and Site Supervisor 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. The play structure appears to be age appropriate for children in care. Areas under slides and other climbing equipment is adequately cushioned. Last Emergency Drill was conducted on 10/17/2024 and properly logged.

During today's visit, a random sample of children's files were reviewed and found to have emergency contact information, required licensing forms and immunization record. Staff’s files were also reviewed and found to be complete. All staff files have proof of education/training, immunization record and required licensing forms. At least one staff have current Pediatric First Aid and CPR.

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.

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

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Winnie Ly
LICENSING EVALUATOR SIGNATURE:

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: CCFC-VV LELAND CENTER (P)
FACILITY NUMBER: 384002242
VISIT DATE: 10/18/2024
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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.

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.

LPA discussed Child Abuse Mandated Training AB1207 with the Site Supervisor. 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 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 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.

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

DATE: 10/18/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2024
LIC809 (FAS) - (06/04)
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Document Has Been Signed on 10/18/2024 03:32 PM - It Cannot Be Edited


Created By: Winnie Ly On 10/18/2024 at 11:21 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: CCFC-VV LELAND CENTER (P)
FACILITY NUMBER: 384002242

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 10/18/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101226(e)(3)(A)
Health-Related Services
(3) Prescription medications may be administered if all of the following conditions are met: (A) Prescription medications shall be administered in accordance with the label directions as prescribed by the child's physician.

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. LPA reviewed medication and one child's Epinephrine has been expired since 08/2024.
POC Due Date: 10/21/2024
Plan of Correction
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Facility Representative must request for new Epinephrine for child and have it ready on site in case of emergency. A picture as proof of new medication obtained must be sent to LPA by 10/21/2024.
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: 10/18/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 10/18/2024


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