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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000830
Report Date: 10/11/2022
Date Signed: 10/11/2022 12:23:23 PM

Document Has Been Signed on 10/11/2022 12:23 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:OUR LADY OF ANGELS PRESCHOOLFACILITY NUMBER:
414000830
ADMINISTRATOR:BIANCHI, COREYFACILITY TYPE:
850
ADDRESS:1341 CORTEZ AVENUETELEPHONE:
(650) 343-3115
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY: 38TOTAL ENROLLED CHILDREN: 38CENSUS: 26DATE:
10/11/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:50 AM
MET WITH:Corey BianchiTIME COMPLETED:
12:30 PM
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On October 11, 2022, Licensing Program Analyst (LPA) Van met with Director Corey Bianchi for an unannounced annual random inspection. The purpose of the inspection was explained, and the Director granted LPA entry to the facility. Present today are 26 children supervised by four teachers and the Director. The facility complies with the staff-children ratios today. All staff members have criminal record clearances on file. The Center operates in the Our Lady of Angels K – 8 school in rooms #1 and #2. The temporary room #3, approved during the case management inspection on 8/3/20, will be removed from the License. LPA will be ordered and sent to the facility upon returning to the office. The days and operations hours are Monday - Friday from 8:30 am to 3:00 pm.

LPA toured and inspected the physical plant for any health and safety hazards. The facility has a record of sign-in/out of children. All parents' signatures matched and accounted for the number of children present. The facility is in good repair and has proper temperature and ventilation. The classrooms have age-appropriate toys and learning materials. The furniture appears steady and in good repair. The facility has multiple carbon monoxide detectors, a centralized smoke alarm, fully charged fire extinguishers, and working telephones. LPA observed that the children have a storage space with hooks for their backpacks/belongings. All emergency supplies are stored in locked storage. First aid supplies are fully stocked and available for children's use. All cleaning solutions, poisons, and other dangerous chemicals are stored in a high cabinet in each classroom and are inaccessible to children. Sleeping cots are appropriately stored. Continued on page 2...
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE: DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 10/11/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OUR LADY OF ANGELS PRESCHOOL
FACILITY NUMBER: 414000830
VISIT DATE: 10/11/2022
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The Center has two toilets and four sinks for children, and the staff has a separate bathroom. In addition, the Center also has a waiver that allows the children to use the school-age bathroom. All toilets and handwashing sinks are in good working condition with proper sanitation. LPA observed no bodies of water on the premises. The outdoor play area is completely fenced, clean, and in good repair. Outdoor toys are age-appropriate, in good condition, and free of loose parts.

The facility had posted the required forms. (i.e., License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Per the Director, the Center does not provide food for the children. The daily schedule is observed and posted. The children bring their water bottles. The Center also has water bottles available for children to refill. All storage containers for solid waste within the Center have a proper tight-fitting cover.

Ten random children's records and personnel records were reviewed during the inspection. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record, medical assessment, and admission agreement can be located in each child's file. Staff records indicate that all staff or individuals requiring caregiver background checks have received criminal records and child abuse index clearances or exemptions. All staff members have a record of valid CPR and maintain proper immunization records. LPA reviewed the educational qualification of the Director and staff, and all staff had the required ECE units. The Director stated that the Center conducts fire and earthquakes monthly; the last drill was conducted on 9/15/2022.

The 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. Continued on page 3...
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OUR LADY OF ANGELS PRESCHOOL
FACILITY NUMBER: 414000830
VISIT DATE: 10/11/2022
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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

The Director was informed about Mandated Reporter training. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticide training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA encouraged the Director to visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email childcareadvocatesprogram@dss.ca.gov and ask for the updates to be added to the email list.

During the inspection, LPA requested Incidental Medical Services Plan (IMS) to be sent to the Licensing office to complete this year's Annual.





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SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: OUR LADY OF ANGELS PRESCHOOL
FACILITY NUMBER: 414000830
VISIT DATE: 10/11/2022
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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/process.

No deficiencies are cited today. An exit interview was conducted, and the report was reviewed with the Director, Corey Bianchi. Today's report, October 11, 2022, and notice of the site visit were provided to the Director. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
SUPERVISORS NAME: Garfield Leung
LICENSING EVALUATOR NAME: Brendon Van
LICENSING EVALUATOR SIGNATURE:

DATE: 10/11/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022
LIC809 (FAS) - (06/04)
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