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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410500494
Report Date: 02/14/2025
Date Signed: 02/14/2025 02:50:22 PM

Document Has Been Signed on 02/14/2025 02:50 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:PACIFICA PLAYSCHOOLFACILITY NUMBER:
410500494
ADMINISTRATOR/
DIRECTOR:		WHEELER, SUZANNEFACILITY TYPE:
850
ADDRESS:630 HICKEY BLVDTELEPHONE:
(650) 359-5673
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY: 44TOTAL ENROLLED CHILDREN: 44CENSUS: 33DATE:
02/14/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
12:30 PM
MET WITH:Suzanne WheelerTIME VISIT/
INSPECTION COMPLETED:
03:30 PM
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On February 14, 2025, at approximately 12:30 PM, Licensing Program Analyst (LPA) Janet Gil conducted an unannounced, annual inspection. LPA met with lead teacher, Suzanne Wheeler, and explained the purpose of the inspection.

Hours of operation are Monday to Friday 7:30 AM to 5:30 PM. Present during inspection included 33 children with 4 staff members (including director). Facility is operating within capacity requirements and ratios at time of LPA's inspection. Facility consists of two classrooms, a kitchen(off-limits), children's bathroom, and outdoor play area.

At approximately 1:30 PM, LPA, inspected facility, indoors and outdoors, for health and safety hazards. Program operates out of two classrooms. Facility has a fully stocked first aid kit backpack, and two fire extinguishers in each classroom, and one in the kitchen area. LPA observed electrical outlets to be made inaccessible with outlet covers. LPA also observed covered trash cans in each classroom. Entire facility has an implemented smoke and fire alarm system. Smoke detectors are dual detectors with carbon monoxide. LPA observed cleaning solutions, poisons and other chemicals are stored inaccessible to children in main classroom's locked closet. Per director, there are no children with allergy medications at the moment.

Storage for children's belongings are located inside each classroom. Storage areas are labeled with each child's individual names. Children's items are properly stored in individual cubbies. Both classrooms have age-appropriate furniture and materials that are in working condition. LPA observed classrooms to have proper temperature and ventilation. LPA observed both classrooms have one accessible children's sink. The bathroom is located between both classrooms and also has four additional accessible sinks and four toilets. Accessible sinks are free of poisons or hazardous materials and do not produce hot water. LPA observed bathroom to be clean and in proper working condition.

Preschool program provides breakfast, lunch, and snack. Drinking water is available to children, indoors and outdoors, with children's individual drinking bottles and accessible outdoor water fountain.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE: DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 02/14/2025
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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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: PACIFICA PLAYSCHOOL
FACILITY NUMBER: 410500494
VISIT DATE: 02/14/2025
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LPA observed back classroom has enough sleeping cots available for all children in care. Per director, facility washes sheets weekly.

LPA observed outdoor area to have age-appropriate materials that are in working condition. Tanbark is located under play structure. LPA observed preschool program to use paper sign in/out system. Classroom has license and all other required documents posted and visible for the public. Preschool program conducts drills every 6 months. Last conducted disaster drill was on 02/12/2025.

LPA reviewed 8 children's files and 4 staff files. Children's and staff files were complete with a record of emergency identification information on file. All staff have valid CPR/First Aid certificates. Mandated Reporter Training Certificates are also on file for each staff. All staff also have proof of required immunization that were made available for review.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare 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.

The Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on al files except one(S2). LPAs encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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/.

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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025
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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: PACIFICA PLAYSCHOOL
FACILITY NUMBER: 410500494
VISIT DATE: 02/14/2025
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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.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

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

Facility representative 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.

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.


No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director, Suzanne Wheeler.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Janet Gil
LICENSING EVALUATOR SIGNATURE:

DATE: 02/14/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2025
LIC809 (FAS) - (06/04)
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