210110894-2-2-2023-05-CC-HLEG-CNNRG8-20230202120020

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 210110894
Report Date: 02/02/2023
Date Signed: 02/02/2023 12:00:26 PM

Document Has Been Signed on 02/02/2023 12:00 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CITY OF SAN RAFAEL- LUCAS VALLEY CHILDREN'S CENTER		FACILITY NUMBER:	210110894
ADMINISTRATOR:	FARIAS, GABRIELA		FACILITY TYPE:	840
ADDRESS:	1175 IDYLEBERRY		TELEPHONE:	(415) 485-3189
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	98	CENSUS: 0	DATE:	02/02/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Gabriela Farias		TIME COMPLETED:	12:15 PM

NARRATIVE

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On 2/2/2023, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Lucas Valley Children's Center. The LPA was granted entry by the Director, Gabriela Farias. The LPA explained the purpose of the visit to the director. All the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. During the visit, there were no children present in the facility.

LPA and the director both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA observed that the playground equipment and outdoor furnishings are in very good shape. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order.

The director has stated that the facility does not house any firearms or other types of weapons.

The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

Because there were no children present in the facility, files pertaining to the children were not reviewed.

The LPA reviewed the records of the director. All required forms were in the files of the director. A review of the training records of the director reveals that she is current with her CPR/First Aid certifications

According to the director, the facility satisfies the requirements by carrying out simulations of fire and earthquake drills twice a year, as well as by documenting their results.

***See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: CITY OF SAN RAFAEL- LUCAS VALLEY CHILDREN'S CENTER	FACILITY NUMBER: 210110894
	VISIT DATE: 02/02/2023

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Continued, Page 2
The following reminders were discussed with the director:
1. All adults 18 and over living or working in a licensed childcare facility, 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 licensed childcare facility.
2. Incidental Medical Services (IMS) policy
3. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

No deficiencies were issued today

A copy of this report, and the “Notice of Site Visit” were given to the director

A “Notice of Site Visit” must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Director, Gabriela Farias

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2023

I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2023

LIC809 (FAS) - (06/04)

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