384003038-12-21-2023-05-CC-LGOZ-CYQRWV-20231221122342

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 384003038
Report Date: 12/21/2023
Date Signed: 12/21/2023 12:23:50 PM

Document Has Been Signed on 12/21/2023 12:23 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	SWEET PEAS PRESCHOOL		FACILITY NUMBER:	384003038
ADMINISTRATOR:	DIONNE, SAMANTHA		FACILITY TYPE:	850
ADDRESS:	1647 VALENCIA STREET		TELEPHONE:	(415) 637-0796
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94110
CAPACITY: 40	TOTAL ENROLLED CHILDREN: 40	CENSUS: 18	DATE:	12/21/2023
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Alvina Lu, Rebecca Wong		TIME COMPLETED:	12:25 PM

NARRATIVE
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25	On 12/21/2023 at 8:30AM., Licensing Program Analyst (LPA), Luis Gomez met with Teacher Alvina Lu. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. This facility is licensed to operate a preschool program. Lead Teacher, Rebecca Wong arrived during inspection. Present was the Lead teacher and 4 staff supervising 18 children. Staff present had criminal record clearances are on file. Children had been signed-in. Preschool program utilizes two large multi-purpose rooms and one, shared, outdoor play area. LPA inspected facility, indoors and outdoors, for health and safety hazards. At 8:40AM., the following was observed: Facility was clean and orderly, with age-appropriate materials available. Floor and ground surfaces were clear of obstructions or hazards. Entry way had labeled cubbies for children's belongings. Accessible furniture, books, art supplies were free of sharp corners or splinters. LPA observed child- sized tables and chairs available for seated activities. Children’s bathroom was maintained clean, with the fixtures in operating condition. Per lead teacher, staff bathroom is located separately. For napping services, several stackable cots are available, and they are made of a cleanable material. Per lead teacher, napping supplies are washed weekly at site. Facility has adequate ventilation and lighting. Outlets and trash bins have coverings installed. Facility has a built-in smoke detectors, testable carbon monoxide detector, functioning telephone, and fire extinguishers: 2A:10:BC. First aid kit reviewed was fully stocked. 9:00AM., Based on observations, LPA confirmed opened wine bottle and beer cans in the kitchen sink. Items were removed during inspection. Per lead teacher, the annual holiday party was held the night prior. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SWEET PEAS PRESCHOOL	FACILITY NUMBER: 384003038
	VISIT DATE: 12/21/2023

NARRATIVE

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At 9:05AM., LPA inspected the outdoor play area. Area was completely enclosed, with a shade rest available for the children. Climbing structures was properly anchored with absorbent padded material installed for added safety. The sandbox has a tarp covering. Playthings inspected were in good repair. Per lead teacher, water services are provided both outside, and inside, with cups.

LPA reviewed the food preparation/storage and facility kitchen. Food items inspected had been properly stored. Kitchen was observed clean and without trash or rubbish.

At 9:30AM., LPA reviewed facility records including: 5 children’s files and 5 personnel files. Staff’s files were reviewed and contained the: Notice of Employee Rights (LIC9052); Teachers Qualifications; and Personnel Record (LIC501).

LPA reminded facility to ensure staff’s proof of required immunization and 'Mandated Reporter Training' (AB1207) are stored in facility records. Advisory Notes: Technical Violations (LIC9102TV) were issued.

Children’s files were reviewed and contained the: Consent for Emergency Medical Treatment (LIC627); Immunization Records, Identification and Emergency Information (LIC700); Notification of Parent’s Rights (LIC995); Personal Rights (LIC613A) and ‘Written Medical Assessments’.

Staff’s updated CPR/ 1^st aid certification was on file, expiring on 8/2025.

Emergency disaster drill are conducted every six month, with last drill completed on 6/22/2023, properly logged.

Required posting had been posted in lobby, including the: Facility License; Emergency Disaster Plan (LIC610); Notification of Parent’s Rights (PUB394); Outdoor Space Waiver; and Child Passenger Safety Laws (PUB269). LPA reminded facility to post snack menu at least one week in advance. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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Document Has Been Signed on 12/21/2023 12:23 PM - It Cannot Be Edited

Created By: Luis Gomez On 12/21/2023 at 11:29 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: SWEET PEAS PRESCHOOL	FACILITY NUMBER: 384003038
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 12/21/2023

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

CCR

101238(g)

Disinfectants, cleaning solutions, poisons and other items that could pose a danger if readily available to children shall be stored where inaccessible to children. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	9:00AM., Based on observations, LPA confirmed opened wine bottles and beer cans in the kitchen sink. This poses a potential health and safety risk to children in care.
	POC Due Date: 12/22/2023
	Plan of Correction
1 2 3 4	Items were moved to an off-limit area during inspection. Deficiency has been cleared.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

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:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Luis Gomez

LICENSING EVALUATOR SIGNATURE:

DATE: 12/21/2023

I acknowledge receipt of this form and understand my appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

Page: 5 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: SWEET PEAS PRESCHOOL	FACILITY NUMBER: 384003038
	VISIT DATE: 12/21/2023

NARRATIVE

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For IMS information see PIN 22-02CCP. 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/.

Lead teacher was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, 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.

Based on today's inspection, deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chap. 1 Ca. Code of Regulations and cited on 809D. Exit interview and report was discussed with Lead Teacher, Rebecca Wong. Signature on this form acknowledges receipt of these documents.

This report must be made available in the facility for public review. Notice of site visit was given and must remain posted for 30 days. Lead Teacher was advised any additional questions to call office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

LPA unable to print report during inspection. Copy of report and pertaining documents will be sent to facility management at a later date.

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:	DATE: 12/21/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/21/2023

LIC809 (FAS) - (06/04)

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