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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 384004089
Report Date: 11/21/2024
Date Signed: 11/21/2024 11:14:10 AM

Document Has Been Signed on 11/21/2024 11:14 AM - 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:EXCELSIOR FAMILY CONNECTIONSFACILITY NUMBER:
384004089
ADMINISTRATOR/
DIRECTOR:		SIHAPANYA, YENSINGFACILITY TYPE:
850
ADDRESS:5016 MISSION STREETTELEPHONE:
(415) 333-3845
CITY:SAN FRANCISCOSTATE: CAZIP CODE:
94112
CAPACITY: 20TOTAL ENROLLED CHILDREN: 20CENSUS: 14DATE:
11/21/2024
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:15 AM
MET WITH:Gia TurnerTIME VISIT/
INSPECTION COMPLETED:
11:30 AM
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Licensing Program Analysts (LPA) Yee conducted an annual inspection today. The purpose of the inspection was explained. Present at the facility are education manager, Gia Turner, two staff members, and 14 children. LPA and the facility representative toured the school for health and safety hazards. The facility has fully charged fire extinguishers that meet the minimum requirements, smoke detectors, and a carbon monoxide detector. The outside yard is adjacent to the classrooms. Days and hours of operations: Monday-Friday, 9:00 am - 4:00 pm

Daycare classrooms: one large room and preschool yard. LPA observed outdoor equipment is in good condition, free from loose, sharp, or pointed parts. Outdoor yards were inspected. LPA observed outdoor equipment are in good condition, free from loose, sharp, or pointed parts. There are no swimming pools, spas, or other bodies of water on the premises. All cleaning supplies and other potentially harmful items are made inaccessible to the children. Furniture and equipment are in good condition. The facility provides morning snacks, afternoon snacks, and children bring their own lunches. Menu is posted. Drinking water is available for indoors and outdoors. The last Fire Drill was conducted on 7-02-2024, earthquake drill was conducted on 9-17-2024 and properly logged.
During the visit, LPA reviewed 02 staff members' records. At least one staff have current Pediatric First Aid and CPR.

LPA discussed the Mandated Reporter Training, AB1207 that was effective on 1/1/2018. All staff must take the training and keep the certificate on file. The training needs to be renewed once every 2 years. https://www.mandatedreporterca.com/. Staff AB1207 certificates are on file.

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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE: DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/21/2024
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: EXCELSIOR FAMILY CONNECTIONS
FACILITY NUMBER: 384004089
VISIT DATE: 11/21/2024
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An isolation room for a sick child is located inside the director office and will use staff bathroom as needed. Designate a teacher to stay with the child, then call parents for pick up.

The facility representative was reminded that all adults 18 and over working in the center, 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 licensed 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 Center (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. The facility had lead water tested and in compliance.

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)/(800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, Available at: http://www.ada.gov/resources/child-care-centers/.

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

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

Exit interview conducted and report was reviewed with the facility representative, by Gia Turner.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jennifer Yee
LICENSING EVALUATOR SIGNATURE:

DATE: 11/21/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/21/2024
LIC809 (FAS) - (06/04)
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