<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384003038
Report Date: 01/16/2025
Date Signed: 01/16/2025 12:17:46 PM

Document Has Been Signed on 01/16/2025 12:17 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 PRESCHOOLFACILITY NUMBER:
384003038
ADMINISTRATOR/
DIRECTOR:		DIONNE, SAMANTHAFACILITY TYPE:
850
ADDRESS:1647 VALENCIA STREETTELEPHONE:
(415) 637-0796
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94110
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 29DATE:
01/16/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:40 AM
MET WITH:Rebecca Wong, Avina LuTIME VISIT/
INSPECTION COMPLETED:
12:35 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 1/16/2025 at 8:40AM., Licensing Program Analyst (LPA), Luis Gomez met with Teacher, Rebecca Wong. The purpose of today's visit was explained and was for an unannounced, annual random inspection. This facility is licensed to operate a preschool-age program. Present was Lead Teacher and 4 staff supervising 29 children. Per teacher, director/licensee is not on-site. The days and hours of operation are Monday- Friday, 8:00-5:00PM. Adults in facility have criminal record clearances on file. Children present had been signed-in by guardians. Program utilizes two classrooms: Art Room, and Center Room and one, shared outside play area. LPA observed approved waiver, for rotational use of 18 children in outdoor space posted in lobby. LPA inspected facility, indoors and outdoors, for health and safety hazards.

At 8:50AM., LPA observed the following: Classrooms were clean, neat, with age-appropriate materials and playthings available for the children. Facility was equipped with several tables, chairs, and labeled cubbies for storage of belongings. All furniture inspected was scaled to the appropriate size. The children’s bathroom was clean with available supplies for handwashing. Facility toilets and faucets were in operating condition. Facility had extra drawers and cabinets for added storage. The food preparation/ storage areas were free of any liter or rubbish. All food items reviewed were current. LPA observed trash bins with tight-fitting lid.

For scheduled rest/ nap services, facility has stackable plastic cots available. Per teacher, blankets and supplies are washed on-site weekly.

At 9:30AM., Based on interview and record review, LPA confirmed facility has not conducted emergency disaster drill within the last six months. (REFER TO 809C, FOR CONT.)

SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE: DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/16/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 7
Document Has Been Signed on 01/16/2025 12:17 PM - It Cannot Be Edited


Created By: Luis Gomez On 01/16/2025 at 11:04 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: 01/16/2025

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
1
2
3
4
At 10:15AM., Based on record review, LPA confirmed facility's lead water testing for outlets used for food preparation or ingestion was conducted after the required due date (1/1/2023). This poses a potential health and safety risk to children in care.
POC Due Date: 01/23/2025
Plan of Correction
1
2
3
4
Per waterboard web page, facility water outlets (2) have been tested without any lead exceedance recorded. Facility will submit testing documentation to Community Care Licensing by the Due date: 1/23/2025.

Proof of correction will be submitted to LPA via email.
Type B
Section Cited
CCR
101174(d)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
At 9:30AM., Based on interview and record review, LPA confirmed facility has not conducted emergency disaster drill within the last six months. This poses a potential health and safety risk to children in care.
POC Due Date: 01/21/2025
Plan of Correction
1
2
3
4
Facility will conducted and document emergency disaster drill by the due date: 1/21/2025.
Proof of correction will be submitted to LPA via email.
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: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2025


LIC809 (FAS) - (06/04)
Page: 2 of 7
Document Has Been Signed on 01/16/2025 12:17 PM - It Cannot Be Edited


Created By: Luis Gomez On 01/16/2025 at 11:04 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: 01/16/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101239(m)(1)
Fixtures, Furniture, Equipment and Supplies
(1) The licensee shall provide a variety of age-appropriate equipment, toys and materials in good condition and in sufficient quantity to allow children present to fully participate in planned activities.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
At 9:55AM., Based on observation, LPA confirmed children on tricycle without proper safety equipment. This poses a potential health and safety risk to children in care.
POC Due Date: 01/23/2025
Plan of Correction
1
2
3
4
Facility will ensure safety equipment is obtained for schedule outdoor play activity (Tricycles) by the due date: 1/23/2025.
Proof of correction will be submitted to LPA via email.
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
1
2
3
4
At 10:30AM., Based on record review, LPA confirmed 5 of 5 staff files reviewed were missing proof of updated mandated reporter training course (AB1207). This poses a potential health and safety risk to children in care.
POC Due Date: 01/31/2025
Plan of Correction
1
2
3
4
Facility will ensure staff renew required mandated reporter training course (AB1207) by the due date: 1/31/2025.
Proof of correction will be submitted to the LPA via email.
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: 01/16/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/16/2025


LIC809 (FAS) - (06/04)
Page: 3 of 7
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: 01/16/2025
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
26
27
28
29
30
31
32
(Page 2)
The classrooms have ventilation; lighting; and was a comfortable temperature. Facility had a functioning telephone service and fire extinguishers (2A10BC). Facility has functioning carbon monoxide detector located in the art room.

At 9:50AM, LPA reviewed the outside play area. LPA observed absorbent rubber padding /turf installed on floors for added safety. Area was completely enclosed with available shading available. The climbing structure was observed anchored to the ground.



At 9:55AM., Based on observation, LPA confirmed children on tricycle without proper safety equipment.

LPA reminded facility to cover corners and sharp edges in outdoor play area. Advisory Note: Technical Violation (LIC9102TV) was issued.

At 10:10AM., LPA reviewed facility records including a sample of the children files and personnel files.
At 10:15AM., Based on record review, LPA confirmed facility's lead water testing for outlets used for food preparation or ingestion was conducted after the required due date (1/1/2023).

The personnel files reviewed contained Teacher's Proof of Qualifications; Notice of Employee Rights (LIC9052); Acknowledgement to Report Suspected Child Abuse (LIC9108); and Personnel Record.

At 10:30AM., Based on record review, LPA confirmed 5 of 5 staff files reviewed were missing proof of updated mandated reporter training course (AB1207).



LPA reminded facility records must contain staff's proof of immunization. Advisory Note: Technical Violation (LIC9102TV) was issued.

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

Staff's Cardiopulmonary Resuscitation / First Aid certification was current, expiring on: 8/2025.



LPA reviewed children's medication during inspection.

Required postings in lobby and in each classroom. Postings including the: Facility License; Notification of Parent’s Rights (PUB394); Personal Rights (LIC613A); The Passenger Safety Laws (PUB269); Outdoor Space Waiver; Menus (weekly); and Emergency Disaster Plan (LIC610). (REFER TO 809C, FOR CONT.)
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
LIC809 (FAS) - (06/04)
Page: 6 of 7
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: 01/16/2025
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
26
27
28
29
30
31
32
(PAGE 3)
LPA referred to the Department website regarding Lead: https://www.cdss.ca.gov/inforesources/child-care-licensing/water-testing-information

Incidental Medical Services (IMS) policy was discussed. 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/.

Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platforms. To receive important licensed related information to licensed facilities, visit the CCLD Important Information website athttps://www.cdss.ca.gov/inforesources/community-carelicensing/subscribe and select the Child Care option to receive email communication.

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. An exit interview discussing the facility evaluation report was conducted with Lead Teacher, Rebecca Wong. Staff’s signature on this form acknowledges receipt of these documents.



This report must be made available in facility for public review. Notice of site visit was provided and must remain posted for 30 days. Teacher was advised, any additional questions/ concerns to contact the office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 01/16/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/16/2025
LIC809 (FAS) - (06/04)
Page: 7 of 7