<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002749
Report Date: 11/15/2023
Date Signed: 11/15/2023 02:08:23 PM

Document Has Been Signed on 11/15/2023 02:08 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 CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME:BUILDING KIDZ OF SSF, INC.(PRESCHOOL)FACILITY NUMBER:
414002749
ADMINISTRATOR:JACQUELINE GALDAMEZFACILITY TYPE:
850
ADDRESS:600 GRAND AVENUETELEPHONE:
(650) 837-9348
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 54TOTAL ENROLLED CHILDREN: 54CENSUS: 51DATE:
11/15/2023
TYPE OF VISIT:Case Management - Lead Testing/ExceedanceUNANNOUNCEDTIME BEGAN:
12:04 PM
MET WITH:Ana GaldamezTIME COMPLETED:
02:10 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 November 15, 2023, Licensing Program Analyst (LPA) Garcia conducted an unannounced, case management inspection for the Action Level Exceedance (ALE) of Lead in Child Care Center's water. In conjunction with the ALE exceedance in the infant license number 414002750 for ALE fixture 'E'. Both licenses 414002750 (infant) and 414002749 (preschool) are located in the same building. LPA met with director, Ana Galdamez. LPA explained the purpose of the visits and was given a tour of the facility. The two licenses' water was tested for lead on January 18, 2023. Both facility licenses are present in facility sketch for the lead water testing documents.
Present in facility are 54 children, with 6 staff members during nap time.

LPA discussed the new Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018 requires the Lead Testing of water in the Child Care Center with the site director during the inspection. All Child Care Centers that are located in buildings constructed before January 1, 2010, must have their water tested and post the results by January 1, 2023, and every 5 years after the date of the first testing.

The facility received the ALE report from the Vendor on February 6, 2023. Test results for this facility that exceeded a higher level of parts per billion (ppb) allowed, 5.5 ppb. The facility was proactive in getting facility faucets tested and barricaded and or made the affected fixture inaccessible for children. The affected fixtures under this license is fixture A (13), C(6.7), D(6.1) and H(11). Per director, fixture A is a hot water sink in the kitchen. Fixture C is a sink in the preschool 2. Fixture D is a diaper changing fixture that was permanently removed back in May. Fixture H is a sink faucet in classroom 3. According to the director, fixture A was replaced in March. Fixtures C and H have been replaced and the facility is in the process of getting all of them a retest schedule. Per director, the facility is using other water sources that passed the lead water testing for food preparation and ingestion/refill. The 'Brita' water pitchers being used have lead specific filters installed.

LPA obtained the copies of the External Water Sampler Self-Certification Form (LIC9275), Child Care Center Sampling Checklist (LIC9276), Facility Sketch (LIC999), in an email to the LPA.

* See next page for deficiencies cited today

This report was reviewed and signed by Director, Ana Galdamez.

This notice of Site visit was provided to the licensee and must remain posted for 30 days.

SUPERVISORS NAME: Daniel J Oquendo
LICENSING EVALUATOR NAME: Nathan Garcia
LICENSING EVALUATOR SIGNATURE: DATE: 11/15/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 11/15/2023
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 11/15/2023 02:08 PM - It Cannot Be Edited


Created By: Nathan Garcia On 11/15/2023 at 01:40 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: BUILDING KIDZ OF SSF, INC.(PRESCHOOL)
FACILITY NUMBER: 414002749

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 11/15/2023
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
12/15/2023
Section Cited

101700.3

1
2
3
4
5
6
7
101700.3 California Lead Action Level at Child Care Centers (b)(1) A result with values of 5.5 ppb or greater shall be deemed an Action Level Exceedance.

This requirement was not met as evidenced by:
1
2
3
4
5
6
7
The facility permanently removed fixtures D and E and fixtures A,C, and H have been replaced. The facility will contact the certified water samplers to schedule for a retest.
8
9
10
11
12
13
14
Based on results received from the certified water samplers, the facility exceeded 5.4 ppb of lead in their water source. This pose a potential health, safety, or personal rights risk to persons in care.
8
9
10
11
12
13
14
LPA will be updated for the retest schedule and for the results, when available by set due date.

1
2
3
4
5
6
7
1
2
3
4
5
6
7

1
2
3
4
5
6
7
1
2
3
4
5
6
7
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:Daniel J Oquendo
LICENSING EVALUATOR NAME:Nathan Garcia
LICENSING EVALUATOR SIGNATURE:
DATE: 11/15/2023
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 11/15/2023


LIC809 (FAS) - (06/04)
Page: 2 of 2