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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002897
Report Date: 03/11/2025
Date Signed: 03/11/2025 05:16:32 PM

Document Has Been Signed on 03/11/2025 05:16 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:ALL SOULS PRESCHOOLFACILITY NUMBER:
414002897
ADMINISTRATOR/
DIRECTOR:		ERIC LIUFACILITY TYPE:
850
ADDRESS:479 MILLER AVENUETELEPHONE:
(650) 871-1751
CITY:SOUTH SAN FRANCISCOSTATE: CAZIP CODE:
94080
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 7DATE:
03/11/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
08:39 AM
MET WITH:Claudia Escobar (Office Manager) and Veronica LamTIME VISIT/
INSPECTION COMPLETED:
05:35 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 3/11/2025, at approximately 9:00AM, Licensing Program Analyst (LPA) Alvarado conducted an unannounced annual visit at the facility. Facility is Located on the All Souls Catholic School property ; Preschool is located in a Portable behind the School campus. LPA Alvarado met with Claudia Escobar(S1) who is the Office Manager for All Souls School. At Approximately 9:30AM acting Director Veronica Lam(D1) arrived at the facility.

Present in the Facility is (S1) and two staff members supervising a total of 7 children (Preschool age). The facility is operating within staffing and ratio requirements on this day. All staff present are fingerprinted, Cleared, and associated to the facility.

LPA was guided by (S1) at approximately 9:30am to inspect the facility for any health or safety hazards. The Facility is a portable that is one large classroom. A children’s bathroom was observed with two stalls and two sinks that are functioning. Facility also has a fenced outdoor play area. No Pools, hot tubs, spas, or similar bodies of water present in the facility.

At approximately 10:25 (S1) guided LPA Alvarado outdoors to inspect the Play Area. Outdoor play area is a black top and a play structure that is fenced in. LPA observed the outdoor play areas to be free of debris and other loose articles. There are age-appropriate toys and equipment present. Outdoor area has a sandbox and parts of the play structures have cushioned landing areas. Each outdoor play area is enclosed by a fence that is at least four feet high.

Facility Building is equipped with one fully charged fire extinguishers. Fire alarm systems and Carbon Monoxide Detector in the facility. Facility has a Fully equipped First Aid Kit. Electrical outlets are childproof and inaccessible. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care.

Continued on Page 2...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE: DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 03/11/2025
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 7
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: ALL SOULS PRESCHOOL
FACILITY NUMBER: 414002897
VISIT DATE: 03/11/2025
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
26
27
28
29
30
31
32
Page 2 Continued...

The facility has not tested its fixtures for lead with the written directive deadline of 1/1/2023.

Per (S1) All Souls Catholic School Provides hot meals by request. (D1) stated that the parents also provide meals from home. Families provide sleeping bags from home to nap on. Facility uses physical paper and logs to ensure that parents sign in and out.

At approximately 3:00PM all children present finished the day and left the facility. At 3:30 LPA Alvarado reviewed 2 staff files, 4 children’s files, and facility records. All children files were observed to be complete. All staff members present have current Pediatric First Aid/CPR training that Expires 12/2025. Staff have qualifications and immunization records available for review. Fire drills are conducted once every 6 months and properly logged, Last Emergency Drill conducted on 2/21/2025. All required postings were observed to be posted and accessible for review upon entry to the facility.

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.

Continued on Page 3...
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC809 (FAS) - (06/04)
Page: 2 of 7
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: ALL SOULS PRESCHOOL
FACILITY NUMBER: 414002897
VISIT DATE: 03/11/2025
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
26
27
28
29
30
31
32
Page 3 Continued...

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. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

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-care-centers/.

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.

See LIC 809-D for deficiencies being cited today on 3/11/2025 under the California Code of Regulations, Title 22, Division 12, Chapter 1. Regarding Physical Plant & Staff Records.

See LIC9102-TA for Technical Advisory in regard to Physical Plant.

Appeal rights were provided. 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 with Facility Director Veronica Lam and Office Manager Claudia Escobar.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Diana Alvarado
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2025
LIC809 (FAS) - (06/04)
Page: 3 of 7
Document Has Been Signed on 03/11/2025 05:16 PM - It Cannot Be Edited


Created By: Diana Alvarado On 03/11/2025 at 04:43 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: ALL SOULS PRESCHOOL
FACILITY NUMBER: 414002897

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
WD
101700(b)
Written Directives for Lead Testing
(b) All licensed Child Care Centers operating in buildings constructed before January 1, 2010, shall test their water for lead pursuant to these written directives.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in one out of one objects, the facility has not tested for lead as stated on the written directives which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 04/11/2025
Plan of Correction
1
2
3
4
Facility will look for a ELAP certified tester and submitt proof to LPA Alvarado that they are in the process of testing for lead. Facility will submitt via email by 4/11/2025 to LPA Alvarado documentaion.
Type B
Section Cited
HSC
1596.8662(b)(1)
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:
Deficient Practice Statement
1
2
3
4
Based on interview and record review, the licensee did not comply with the section cited above in one out of one persons, once staff member did not have a current Mandated Reporter Training which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 03/28/2025
Plan of Correction
1
2
3
4
Facility will submitt via email to LPA Alvarado proof of the completed Mandated Reporter Training via email by 3/28/2025.
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:Ali Zebila
LICENSING EVALUATOR NAME:Diana Alvarado
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2025


LIC809 (FAS) - (06/04)
Page: 4 of 7