213001117-2-26-2020-05-CC-FBTQ-BM6S93-20200226124003

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213001117
Report Date: 02/26/2020
Date Signed: 02/26/2020 12:40:12 PM

COMPREHENSIVE INSPECTION

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:	JCC PRESCHOOL SAN RAFAEL		FACILITY NUMBER:	213001117
ADMINISTRATOR:	RACHEL FALK		FACILITY TYPE:	850
ADDRESS:	200 N. SAN PEDRO ROAD		TELEPHONE:	(415) 444-8042
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94903
CAPACITY:	150	CENSUS: 71	DATE:	02/26/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Rachel Falk		TIME COMPLETED:	01:00 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	Licensing Program Analyst (LPA) Farhan Bashir-Tariq met with site Director, Rachel Falk, to conduct an Annual Inspection on 02/26/20. Purpose of the inspection was explained. Present, there were 71 children in care with 16 staff members and Director. There are 7 classrooms and 3 playgrounds available to the children. Center uses one additional classroom for an art studio. Sign in and out sheets were available and reviewed outside every classroom. Facility is operating within the capacity and is following staff child ratio on this day. LPA toured each room to check the staff and child ratio and verified the background check clearance for staff present today. Facility operates day care from Monday to Friday between 7:30 AM to 6:00 PM. Facility provide two snacks to children in care and menus for snacks were observed posted in every classroom. LPA inspected the facility indoors and outdoors with Director. Per Director, there are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors, fully charged fire extinguishers and a working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight-fitted lid on top. Play yards are free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is a sufficient amount of wood chunks or artificial grass under the play structures to prevent any fall injuries. There is a separate bathroom on site for staff and other adults. The floors are clean and free of debris or other tripping hazards. Drinking water is provided to the children by cups and/or drinking fountains both indoors and outside. LPA reviewed the facility records. LPA reviewed 10 random children's and 5 random staff's files including Director. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contains the record immunization. Multiple staff members have record of valid CPR card in file. LPA reviewed the educational qualification of all the teachers. Facility has a log for emergency drills being conducted. Per log, last earthquake drill was conducted on 10/18/19 and fire drill on 1/15/20. Continuation on next page...

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

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: JCC PRESCHOOL SAN RAFAEL	FACILITY NUMBER: 213001117
	VISIT DATE: 02/26/2020

NARRATIVE

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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

LPA reminded the facility that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. Immunization records were reviewed for teachers and Director in files.

LPA reminded the facility, As of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. Multiple staff members have completed the training and certificates were observed in staff files. LPA encouraged the facility to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Facility can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations. This report and rights to comment and appeal were discussed with Director. This report must be available in the facility for public review. Notice of site visit shall be posted for 30 days from today's visit. Facility was advised for any additional questions to call Office, M-F, 8AM-5PM at 650-266-8800 . For Rules and Regulations, visit the Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-Tariq	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/26/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/26/2020

LIC809 (FAS) - (06/04)

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