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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410505727
Report Date: 09/06/2024
Date Signed: 09/06/2024 01:01:45 PM

Document Has Been Signed on 09/06/2024 01:01 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:RAINBOW PRESCHOOL & DAY CAREFACILITY NUMBER:
410505727
ADMINISTRATOR/
DIRECTOR:		BAUTISTA, ROSEANNEFACILITY TYPE:
850
ADDRESS:2223 VERA AVENUETELEPHONE:
(650) 367-4025
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY: 22TOTAL ENROLLED CHILDREN: 18CENSUS: 3DATE:
09/06/2024
TYPE OF VISIT:Case Management - DeficienciesUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
11:30 AM
MET WITH:Rosanne BautistaTIME VISIT/
INSPECTION COMPLETED:
01:15 PM
NARRATIVE
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On September 6, 2024, Licensing Program Analyst (LPA) Maria Olguin-Leon conducted a case management inspection and met with Director Rosanne Bautista. LPA explained the purpose of case management visit, which was to cite deficiencies observed during today’s inspection. LPA inspected facility for health and safety hazards.

At 11:00am., Based on record review, interview, and observation, LPA confirmed the three staff members present do not have mandated reporter training. During children’s file review, LPA observed four out of four children’s files were missing LIC995 Parents rights. Two type B deficiencies were issued as this poses a potential health and safety hazard.


Based on today's inspection, deficiencies were observed in areas evaluated according to California Title 22, Div. 12 Chap. 1, Health and Safety, Code of Regulations and cited on 809D.



LPA conduct exit interview and reviewed report with Director, Rosanne Bautista, including plans for correction.
A copy of this report and appeal rights were reviewed and provided. Notice of site visit was given and must remain posted for 30 days.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE: DATE: 09/06/2024
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 09/06/2024
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 2
Document Has Been Signed on 09/06/2024 01:01 PM - It Cannot Be Edited


Created By: Maria Olguin-Leon On 09/06/2024 at 12:29 PM
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: RAINBOW PRESCHOOL & DAY CARE
FACILITY NUMBER: 410505727

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 09/06/2024
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
09/13/2024
Section Cited
CCR
101218.1(e)(1)

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101218.1 Admission Procedures and Parental and Authorized Representative's Rights (e) At the time of acceptance of each child into care and for all children in care on August 7, 2002, the licensee shall give each parent or authorized representative a copy of the Notification of Parents' Rights (LIC 995 [8/02]) and the LIC 995E, Caregiver Background Check Process form. (1) The licensee shall request the child’s parent or authorized representative to sign and date the acknowledgement-of-receipt statement at the bottom of the LIC 995 (8/02). The bottom portion of this form must be kept in the child's file as proof that the parent or authorized representative has been notified of his or her rights by the child care center and received a copy of the LIC 995E, Caregiver Background Check Process form.

This requirement is not met as evidenced by:
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Licensee will provided parents with LIC995 and have parents acknowledge and sign form. LIcensee will email copies of signed LIC995 forms to LPA by POC date.

Office meeting to be scheduled
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Based on interview and record review, the licensee did not comply with the section cited above in 4 out of 4 children's files did not have a signed copy of LIC995 Parents Rights, which poses/posed a potential health, safety or personal rights risk to persons in care.
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Type B
09/13/2024
Section Cited
HSC1596.8662(b)(1)

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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:
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Licensee will complete Mandated reporter training on mandatedreporterca.com and submitted certificate of completion to LPA by POC due date.

Office meeting to be scheduled
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Based on interview and record review, the licensee did not comply with the section cited above in licensee and staff have not completed mandated reporter training, which poses/posed a potential health, safety or personal rights risk to persons in care.
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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:Marie Rodriguez
LICENSING EVALUATOR NAME:Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:
DATE: 09/06/2024
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 09/06/2024


LIC809 (FAS) - (06/04)
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