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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000489
Report Date: 01/23/2025
Date Signed: 01/23/2025 12:12:51 PM

Document Has Been Signed on 01/23/2025 12:12 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:IHSD, INC-SERRAMONTE HEAD START CENTERFACILITY NUMBER:
414000489
ADMINISTRATOR/
DIRECTOR:		ZOHREH KHOSHENEVISIANFACILITY TYPE:
850
ADDRESS:699 SERRAMONTE BLVD.TELEPHONE:
(650) 992-6027
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY: 40TOTAL ENROLLED CHILDREN: 40CENSUS: 33DATE:
01/23/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:30 AM
MET WITH:Claudia MontepequeTIME VISIT/
INSPECTION COMPLETED:
12:30 PM
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On January 23, 2025 at approximately 8:30am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with site supervisor, Claudia Montepeque, and explained the purpose of the visit.

Preschool program operates in Classroom A and Classroom B. Hours of operation are Monday through Friday 8:00am to 4:00pm. In conjunction with annual inspection is a case management visit. Program previously reported to department an unusual incident in regards to a water leak in classroom B.

Present during LPA's visit included 33 preschool children, 7 teaching staff (including site supervisor), volunteer and ABA specialist. Classroom A included 17 preschool children with 2 teachers and 1 teacher assistant. Classroom B included 16 preschool children with 1 teacher, 2 teaching assistants, and 1 volunteer. Preschool program is operating within capacity limits and ratio. Teaching staff (including volunteer) present have fingerprint clearance on file.

With site supervisor, LPA inspected classrooms and outdoor area for health and safety hazards. LPA observed classrooms to be clean. LPA observed exit doors to classrooms to have a sound alarm/doorbells installed. There are carpets in the classrooms that are free of stains. Per site supervisor, carpets are vacuumed daily.

LPA observed classrooms to be equipped with a variety of children's toys and materials that are in good condition. Classrooms include activities for housing/dramatic play, writing, quiet area, manipulative, science and arts and crafts. LPA observed cleaning solutions and chemicals to be made inaccessible in classrooms' high shelves. LPA observed cabinets and drawers in each classroom to have child safety locks installed.

Storage for children's belongings are located inside the classroom, labeled with children's names and numbers. Children sleep in each classroom on cots or mats. Sheets are provided by the program that are laundered weekly or as needed. Children's individual blankets are stored appropriately and are also sent home weekly for laundering. LPA observed floor mats to be stored appropriately, so sheets are not touching each other. LPA also observed floor mats to be color coded so a specific side of the mat touches the floor only. LPA observed both cots and mats to be appropriately labeled with either children's names or the child's specific number.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE: DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/23/2025
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: IHSD, INC-SERRAMONTE HEAD START CENTER
FACILITY NUMBER: 414000489
VISIT DATE: 01/23/2025
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LPA observed classrooms to be equipped with a fully charged fire extinguisher, smoke alarm, smoke detector and carbon monoxide detector. Per director, carbon monoxide detector is changed every season. Both classrooms have a first aid cabinet, emergency supplies and an emergency backpack that is brought to the outdoor area daily.

Outdoor area is fully enclosed and fenced. LPA observed outdoor area to have a variety of outdoor toys and materials in good condition. There is sufficient shade in outdoor area. There is a play structure in the outdoor area that has resilient padding underneath. LPA observed sand box in outdoor area to be appropriately covered when not in use. LPA did not observe any bodies of water or pools on site.

Drinking water is available both in doors and outdoors with children's individual water bottles that can be refilled on site through accessible sinks in each classroom. LPA observed sinks to be in working condition.

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.

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

Restrooms for children's use was observed to be in working condition. Restrooms include appropriate sanitation and toileting equipment for children's use. There are enrolled children who are currently in diapers Preschool program provides diapers and wipes to diapering children. Per director, diapering procedures include changing paper that is changed after each child's use. LPA observed garbage bins in children's restrooms and classrooms to have tight fitting lids.

Program provides a food service that includes breakfast, lunch and snack. LPA observed menu to be properly posted and available for review. LPA did not observe cleaning solutions and snacks to be stored near food items served to children.

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) 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-carecenters/.
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SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
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: IHSD, INC-SERRAMONTE HEAD START CENTER
FACILITY NUMBER: 414000489
VISIT DATE: 01/23/2025
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Children are signed into and out of program with authorized representatives' electronic signatures. LPA observed all children present during today's visit to be appropriately signed in. Sign in and out includes the child's individual name and the time they are signed into and out of program.

LPA reviewed 6 random children's records. Children's records are complete with emergency contact information. A child care roster is posted in each classroom. LPA reviewed all teaching staff's files during visit. Multiple teaching staff on site have a current CPR/First Aid certification. All teaching staff present have proof of their required immunizations and educational transcripts/permits, available for LPA's review. Teaching staff also have a current Mandated Reporter certification on file. LPA observed a volunteer agreement for volunteer present. LPA also observed ABA specialist agreement for ABA specialist present.

Licensing documents are properly posted and available for review in each classroom. Emergency disaster drills are conducted monthly and are appropriately documented. Last disaster drill was conducted 1/22/2025. LPA reminded site supervisor of facility's annual fees.

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

Facility representative was reminded that all adults 18 and over, 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 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.

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

No deficiencies were issued during today's visit.

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

Exit interview conducted and report was reviewed with facility representative, Claudia Montepeque.
SUPERVISORS NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Catrina Quimbo
LICENSING EVALUATOR SIGNATURE:

DATE: 01/23/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/23/2025
LIC809 (FAS) - (06/04)
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