213001939-2-7-2023-05-CC-NGAA-CNTW53-20230207155827

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213001939
Report Date: 02/07/2023
Date Signed: 02/07/2023 03:58:34 PM

Document Has Been Signed on 02/07/2023 03:58 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:	C.A.M. (CFS) HAMILTON (PS)		FACILITY NUMBER:	213001939
ADMINISTRATOR:	LOMBARDI KELSEY		FACILITY TYPE:	850
ADDRESS:	5520 NAVE DRIVE		TELEPHONE:	(415) 883-3791
CITY:	NOVATO	STATE: CA	ZIP CODE:	94949
CAPACITY:	80	CENSUS: 42	DATE:	02/07/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:49 AM
MET WITH:	Alida Leon		TIME COMPLETED:	04:15 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 February 7, 2023 at approximately 10:30 AM, Licensing Program Analyst (LPA) Nathan Garcia met with Site Supervisor, Alida Leon for an unannounced annual inspection, in conjunction with lead Case Management and opening complaint investigation. Purpose of the inspection was explained. Present in the facility are the office staff, site manager, and 11 teachers, including floaters, supervising 42 children. Facility is operating within its capacity and is in compliance with staff/child ratio on this day. Facility operates day care Monday - Friday 7:30am to 5:30pm. With Supervisor, LPA inspected 3 day care rooms and the outdoor space. LPA observed facility has combined smoke detectors and carbon monoxide detectors, 3 fully charged fire extinguisher model 3A40BC located on multiple areas and in each rooms. The facility has a working telephone on site. All cleaning solutions, poisons, and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age-appropriate furniture. Facility floor and rugs are in good repair and free of any hazards. There are first aid supplies available in the classrooms and in the office. All bathrooms are in working condition. All food is stored properly to avoid contamination. Facility has enough sleeping cots/mats available and provides sheet/blankets from the facility. The blankets are provided and washed on site. Individual items provided by the parents are labeled and stored appropriately. According to Alida, the snacks and lunches are prepped and served at the facility. Per supervisor, the children are provided through kitchen sink as main source of drinking water. The water is filtered through Brita water pitchers and water bottles are washed on site. Foods are nut-free and food preparation area is free of litter. Food is stored adequately to prevent contamination and properly labeled. There is water available for children in the yard as well as in the classrooms and emergency bags. LPA observed outdoor area and play structures are free from health and safety hazards. The sand boxes are well maintained and checked/covered after each use. There are a variety of bicycles and sport equipment available for the children. There are also sheds/bins and storage areas for the toys when they're not being used. *page 2 for continuation*

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

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: C.A.M. (CFS) HAMILTON (PS)	FACILITY NUMBER: 213001939
	VISIT DATE: 02/07/2023

NARRATIVE

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According to the director, the facility is using paper for sign in/out sheet. LPA observed that all authorized representatives have signed. Facility has license and all other required documents posted and visible for the public. Facility has an emergency drill log and last drill was conducted on January 27, 2022. Per Alida, drills are done every 2-3 months.

The LPA reviewed the facility records. LPA reviewed 6 random children's files. All required files were available in folders. LPA reviewed 6 staff files with qualifying requirements such as ECE Units, CPR and Mandated Reporter Training. The facility has a set learning curriculum that includes story time, and movement posted in the classroom.

The Director was reminded that all adults 18 and over, 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 Child Care Center.

A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

Facility was informed 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.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file.

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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: C.A.M. (CFS) HAMILTON (PS)	FACILITY NUMBER: 213001939
	VISIT DATE: 02/07/2023

NARRATIVE

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This facility provides Incidental Medical Services – IMS. According to the director, there are no children with allergies, just inhalers and lactose restrictions. LPA checked and observed that the medications were properly stored. 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

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3. This report must be available in the facility for public review.

Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

Report was reviewed and signed by Site Manager, Alida Leon.

Today’s report, and notice of site visit will be printed and given to the director.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 379-9023
LICENSING EVALUATOR NAME: Nathan Garcia	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/07/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/07/2023

LIC809 (FAS) - (06/04)

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