410509589-1-30-2023-05-CC-CQUO-CNKSCW-20230130124609

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410509589
Report Date: 01/30/2023
Date Signed: 01/30/2023 12:46:56 PM

Document Has Been Signed on 01/30/2023 12:46 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	HOPE LUTHERAN DAYSCHOOL		FACILITY NUMBER:	410509589
ADMINISTRATOR:	HUANG, CYNTHIA		FACILITY TYPE:	850
ADDRESS:	55 SAN FERNANDO WAY		TELEPHONE:	(650) 991-4673
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY: 170	TOTAL ENROLLED CHILDREN: 144	CENSUS: 122	DATE:	01/30/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:15 AM
MET WITH:	Shirley Ngai & Cynthia Huang		TIME COMPLETED:	01:00 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 January 30, 2023 at approximately 9:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with both assistant to director, Shirley Ngai, and center director, Cynthia Huang, and explained the purpose of the inspection. Present during LPA's visit included 21 staff members (including directors) and 122 preschool age children. Facility is operating within capacity limits and ratio during LPA's visit. All individuals working at facility have record of fingerprint clearance on file. Hours of operation are Monday to Friday 7:30am to 6:00pm. Program is licensed to operate in classrooms #1 through #12, three play yards and Parish hall (lunch purposes). Currently, program is operating in classrooms #4 through #12, three play yards and Parish hall. Facility is a multi-level facility that includes 2 stair cases that are made inaccessible with child safety gates when not in use. Children 2 years old attend the Ducklings classroom that is located near Church office. Children ages 3 years to 4 years old attend classrooms (Colts, Dolphins, Bunnies, and Owls) on the first level of the building. Children ages 4 years to 5 years attend classrooms (Lemurs, Alligators, Penguins, and Bears) on the second level of the building. With assistant to director, LPA inspected day care areas currently in use, for health and safety hazards. LPA observed Parish hall to be used for lunch services only. Children eat lunch in Parish hall and eat snack in designated classrooms. Parish hall is appropriately set up with children's furniture and utensils that were observed to be clean and orderly. Hall includes a kitchen that is off limits to children. LPA did not observe any poisons or cleaning materials to be located in kitchen. (Continue Report on Page 2...)

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: HOPE LUTHERAN DAYSCHOOL	FACILITY NUMBER: 410509589
	VISIT DATE: 01/30/2023

NARRATIVE

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LPA observed each classroom to be equipped with a fully charged fire extinguisher and fully stocked first aid kits. Entire facility has an installation of a smoke and fire alarm system. Per assistant to director, smoke detectors in classrooms are dual carbon monoxide detectors.

Each level of facility also includes restrooms that are separated into "Boys" and "Girls" bathrooms. LPA observed bathrooms to be in proper working order with appropriate sanitation products. Per assistant to director, staff have access to adult restrooms located in Parish hall. Ducklings classroom also includes a separate bathroom for diapering children who are potty training.

LPA observed cleaning supplies, poisons and other chemicals to be stored inaccessible in classrooms, behind child safety locked cabinets or located in classroom's high shelves. LPA observed classrooms to have age appropriate furniture and materials that were in good working condition. Storage for children's belongings are located inside each classroom, labeled with each child's individual names. Each classroom has sufficient amount of sleeping cots available for napping children in care. Children's sheets are stored in their personal cubbies.

LPA observed electrical outlets in classrooms to be made inaccessible with child safety covers. Each classroom also includes an accessible sink to children. Sinks do not provide water that is warmer than 120 degrees Fahrenheit.

Facility includes three play yards that were observed to be clean and in good condition. Play yards are equipped with appropriate toys and materials. Play yards also include play structures that were observed to have resilient padding underneath climbing structures. Children have access to water both indoors and outdoors through children's individual water bottles and/or water pitchers with disposable cups. Water pitchers are refilled in filtered water fixture in Parish hall and is made available when needed.

LPA observed program to use electronic sign in/out system through application. Last emergency disaster drill was conducted 10/26/2022. Emergency drills are properly documented and maintained.
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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: HOPE LUTHERAN DAYSCHOOL	FACILITY NUMBER: 410509589
	VISIT DATE: 01/30/2023

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LPA reviewed 6 children's files, 6 staff files (including director's file). Children's and staff files were complete. Children's files have record of emergency identification information on file. Parent volunteers and staff members' immunizations were made available for review. Staff members' Mandated Reporter training certificates were available for review and are current. Director is aware that all staff hired are required to complete Mandated Reporter Training every two years.

Multiple staff members on site have a current, CPR certification on file. Director's CPR and First Aid certificate is current and will expire 08/2024.

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

Director was reminded that all adults 18 and over, including employees and volunteers, 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 up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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/childqanda.htm

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 was conducted and report was reviewed with director, Cynthia Huang.

SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:	DATE: 01/30/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/30/2023

LIC809 (FAS) - (06/04)

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