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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004317
Report Date: 01/09/2025
Date Signed: 01/09/2025 02:09:37 PM

Document Has Been Signed on 01/09/2025 02:09 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:HAPPY CAMPERS AT CARLMONT HIGH SCHOOLFACILITY NUMBER:
414004317
ADMINISTRATOR/
DIRECTOR:		SPAULDING, GINAFACILITY TYPE:
830
ADDRESS:1400 ALAMEDA DE LAS PULGASTELEPHONE:
(650) 678-8244
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY: 24TOTAL ENROLLED CHILDREN: 24CENSUS: 8DATE:
01/09/2025
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME VISIT/
INSPECTION BEGAN:
09:00 AM
MET WITH:Director, Felicia EvansTIME VISIT/
INSPECTION COMPLETED:
02:20 PM
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On 1/9/2025, at approximately 9:00AM, Licensing Program Analysts (LPAs) Jonathan Tse and Jaclyn Naves conducted an unannounced annual visit at the facility. LPAs met with Director Felicia Evans (D1) and explained the purpose of the visit. Present during the visit was D1, two staff members, and eight infants. The facility’s hours of operation are from 7:30AM to 5:15PM.

This facility is a combination center with a preschool center (facility #414004571) located on the premises of Carlmont High School. LPAs and D1 inspected the facility for any health or safety hazards. LPAs observed there to be fully charged fire extinguishers that are at least size 2A10BC. There is a fire alarm system running throughout the facility. Electrical outlets are covered or blocked by furniture to be inaccessible. LPAs observed a staff member’s thermos present in the infant play area and advised that staff beverages shall be placed out of reach of children in care. D1 stated that they understood and removed the thermos from the play area. Poisons, cleaning detergents, and other chemicals are stored inaccessible to children in care.

LPAs observed there to be age-appropriate toys and learning materials present. Furniture and toys are age-appropriate and free of rough or sharp edges. The infant napping area is kept separate from infant play areas with barricades. LPAs observed cribs to be in good repair. LPAs advised that cribs are to be kept free of objects and other loose materials. D1 stated that they understood. Mats are also available for infants to nap on. Per D1, mats are wiped down daily. Bedding is brought from home and taken home once a week for cleaning. Milk is brought from home and stored in a refrigerator with labels. Lunch is brought from home and prepared by the facility.




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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE: DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 01/09/2025
This report must be available at Child Care and Group Home facilities for public review for 3 years.

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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: HAPPY CAMPERS AT CARLMONT HIGH SCHOOL
FACILITY NUMBER: 414004317
VISIT DATE: 01/09/2025
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LPAs observed the outdoor play area to be free of debris and other loose materials. There are age-appropriate toys and equipment present. LPAs observed that there is a small gap between the flooring of the infant area and the fence. LPAs advised that the gap could be covered with a soft surface such as a pool noodle to minimize the risk of infants stepping into the gap or putting foreign objects in their mouths. D1 stated that they understood. There are no swimming pools or other similar bodies of water present in the facility. There are no firearms or weapons stored in the facility.

LPAs reviewed three staff files, five children’s files, and facility records. There is at least one staff member present with current Pediatric First Aid/CPR training. LPAs observed that two staff members (S1 and S2) were not associated to the facility. LPAs advised D1 of steps to take to acquire fingerprint clearance and transfer associations. LPAs advised that S1 was not to be present at the facility until they acquire fingerprint clearance. LPAs provided D1 with a Criminal Record Background Transfer Request form for S2. D1 stated that they understood. S2 was associated to the facility during the visit. LPAs informed D1 that a Type A deficiency would be cited and that a civil penalty of $600 would be assessed. D1 stated that they understood.

LPAs observed that all children’s files were complete. Infant needs and services plans were available for review. Infant sleeping logs are maintained and recorded digitally. LPAs observed required postings to be posted and accessible for review immediately upon entry to the facility. LPAs advised that emergency drills are to be properly logged and documented. D1 stated that they understood.

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.
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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
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: HAPPY CAMPERS AT CARLMONT HIGH SCHOOL
FACILITY NUMBER: 414004317
VISIT DATE: 01/09/2025
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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).

LPA referred facility representative to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

LPA discussed the safe sleep regulations with facility representative and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-andresources/safe-sleep as an additional resource. LPA also informed facility representative of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

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-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.



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SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
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: HAPPY CAMPERS AT CARLMONT HIGH SCHOOL
FACILITY NUMBER: 414004317
VISIT DATE: 01/09/2025
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See LIC809-D for Type A deficiency cited today regarding fingerprint clearance requirements. See LIC9102-TV for technical violations issued regarding keeping cribs free of objects, documenting emergency drills, keeping lids on trash bins with solid waste, and maintaining complete immunization records for staff members. See LIC9102-TA for technical assistance given today regarding submitting a change of director packet.

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

Exit interview conducted and report was reviewed with the facility representative Felicia Evans.

LPAs Tse and Naves informed facility representative Felicia Evans that this report dated 1/9/2025 documents one Type A citation which shall be posted for 30 consecutive days as there is/are immediate risk(s) to the health, safety, or personal rights of children in care.

Also, LPAs Tse and Naves informed the facility representative to provide a copy of this licensing report dated 1/9/2025 that documents any Type A citations to parents/guardians of all children currently enrolled by the next business day or the next day the children are in care, and to any newly enrolled parents/guardians for 12 months from the date of this report. A signed Acknowledgement of Receipt of Licensing Report (LIC 9224), or other written statement, must be placed in the child's file for verification.
SUPERVISORS NAME: Ali Zebila
LICENSING EVALUATOR NAME: Jonathan Tse
LICENSING EVALUATOR SIGNATURE:

DATE: 01/09/2025
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/09/2025
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Document Has Been Signed on 01/09/2025 02:09 PM - It Cannot Be Edited


Created By: Jonathan Tse On 01/09/2025 at 12:51 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: HAPPY CAMPERS AT CARLMONT HIGH SCHOOL
FACILITY NUMBER: 414004317

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 01/09/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type A
Section Cited
HSC
1596.871(c)(1)(A)
Administration of Child Day Care Licensing
Subsequent to initial licensure, a person specified in subdivision (b) who is not exempt from fingerprinting shall obtain either a criminal record clearance or an exemption from disqualification, pursuant to subdivision(f) of this section or Section 1522.7, from the State Department of Social Services prior to employment, residence, or initial presence in the facility.

This requirement is not met as evidenced by:
Deficient Practice Statement
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Based on record review, the licensee did not comply with the section cited above by having two staff members present without fingerprint clearance or association which poses an immediate health, safety or personal rights risk to persons in care.
POC Due Date: 01/10/2025
Plan of Correction
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Licensee shall have S1 fingerprinted and submit the receipt to LPA via email. D1 completed an LIC9182 for S2 during the visit and LPAs associated them to the facility.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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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:Jonathan Tse
LICENSING EVALUATOR SIGNATURE:
DATE: 01/09/2025
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 01/09/2025


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