213004686-2-15-2022-05-CC-HRCO-CBNNED-20220215092347

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213004686
Report Date: 02/09/2022
Date Signed: 02/15/2022 09:25:21 AM

Document Has Been Signed on 02/15/2022 09:25 AM - It Cannot Be Edited

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:	SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CARE		FACILITY NUMBER:	213004686
ADMINISTRATOR:	CORT, DAVE		FACILITY TYPE:	840
ADDRESS:	6350 SIR FRANCIS DRAKE BLVD.		TELEPHONE:	(415) 488-8888
CITY:	SAN GERONIMO	STATE: CA	ZIP CODE:	94963
CAPACITY:	52	CENSUS: 0	DATE:	02/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:47 AM
MET WITH:	Nicole Ramirez		TIME COMPLETED:	11:35 AM

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) Haydee Caliboso met with Nicole Ramirez, Director of Human Services & Youth Programs to conduct an unannounced annual inspection on 02/09/22. LPA arrived at the facility at 10:15AM. The purpose of the inspection was explained. There were no children present during the inspection. The facility operates Monday – Friday, 12:00PM to 5:30PM during school year calendar. The facility was inspected today, indoors and outdoors for health and safety hazards. LPA observed no bodies of water at the facility. Nicole Ramirez stated there are no firearms or weapons in the facility. The facility is equipped with smoke detector, carbon monoxide detectors, fully charged fire extinguishers and a working telephone available. The classrooms have adequate ventilation and lighting. LPA observed all cleaning solutions, poisons and other chemicals that are dangerous to the children are stored made inaccessible to the children. The classrooms are equipped with age-appropriate toys and furniture. The furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. LPA observed toilets and hand washing equipment are in working condition with proper sanitation in place. The program has drinking water available for children for indoors and outdoors. Outdoor play structures are age appropriate and in good working condition, free of loose parts, free of hazard, and with sufficient cushion underneath. First aid kit and emergency supplies are properly maintained and kept inaccessible to children. Director of Youth Programs stated that there are no children in the program who currently have medication in care. Cont. 809-C pg. 2

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

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: SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CARE	FACILITY NUMBER: 213004686
	VISIT DATE: 02/09/2022

NARRATIVE

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LPA reviewed personnel files during today’s inspection. LPA observed files are up-do-date.Facility has a log for emergency drills being conducted. Per log, last emergency drill was conducted on 10/2021. Per Director of Youth Programs, the program is currently not providing transportation due to pandemic.

The Director was reminded about Mandated Reporter training available on the CCLD website. In addition to the AB1207 a total of 7 hrs training must be completed every two years by all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Nicole Ramirez was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA informed the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates. Licensee 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

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.

Cont. 809-C pg. 3

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

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: SAN GERONIMO VALLEY COMMUNITY CENTER CHILD CARE	FACILITY NUMBER: 213004686
	VISIT DATE: 02/09/2022

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To improve the quality and value of the new inspection process, a survey will 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 tools, please send them by email 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/process

The report was reviewed and signed by the Director, Nicole Ramirez. 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 conducted and report was reviewed with Nicole Ramirez. Today’s report and notice of site visit will be sent to the Director by the end of the day on 02/09/22. Confirmation of receipt is required.

>No deficiencies were cited today under Title 22 Division 12 of the California Code of Regulations.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022

LIC809 (FAS) - (06/04)

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