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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 213005161
Report Date: 09/15/2021
Date Signed: 09/15/2021 04:04:49 PM

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:UNIVERSITY OF PLAYFACILITY NUMBER:
213005161
ADMINISTRATOR:BALLENGER, SYLVIAFACILITY TYPE:
850
ADDRESS:1055 LAS OVEJAS AVE RM#4TELEPHONE:
(415) 499-0309
CITY:SAN RAFAELSTATE: CAZIP CODE:
94903
CAPACITY:30CENSUS: 12DATE:
09/15/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Sylvia Ballenger TIME COMPLETED:
04:15 PM
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Licensing Program Analyst (LPA), Farhan Bashir-Tariq arrived at the facility above unannounced to conduct a required one-year inspection and met with Director, Sylvia Ballenger. Purpose of inspection was explained. There were 12 preschool children present with two teachers and two aids. LPA verified the background check clearance for all staff present today. Facility is operating in compliance to the required capacity and ratio limits as of today 9/15/21. Hours of operation are: M-F, 8:00 AM - 5:00 PM. Facility does not provide any food at present. However, emergency food supplies were observed to be available.

LPA and Director inspected the facility indoors and outdoors for health and safety hazards. Facility have two classrooms, Freshman's and Seniors. Classrooms have age appropriate toys and equipment that are in good repair. Cubbies are available in both classrooms to store children’s belongings. Facility has two outdoor spaces available for children in care, big playground and garden space. Outdoor play areas were free of debris and dangerous conditions. All outdoor toys and equipment are in good condition. Soft cushioning has been installed under play structure to prevent any falls or injuries. Both outdoor grounds were fully fenced all around. Both classrooms are equipped with smoke detectors, carbon monoxide detectors and fire extinguishers. Classroom has proper ventilation and sufficient lighting. Facility has toilets available for children in care in senior’s classroom. Toilets are maintained clean, in good repair, and with adequate supplies and proper sanitation. Hand washing posters were observed to be posted in bathroom. First Aid Kit and emergency supplies are properly maintained and kept inaccessible to children. Facility has plenty of supplies of masks, sanitizers and cleaning wipes. Staff were observed to be wearing masks. Cleaning products and toxins are maintained in cabinet above sink. License and other required licensing documents were observed to be posted in seniors’ classroom. LPA reviewed the facility records. LPA reviewed 9 random children's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's file contains the record of immunization. Facility has a log for emergency drills being conducted. Per log, last emergency drill was conducted on June 2021.


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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 2
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: UNIVERSITY OF PLAY
FACILITY NUMBER: 213005161
VISIT DATE: 09/15/2021
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. 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 Director that as of January 1, 2018, all staff is required to complete Mandated Child Abuse Reporter Training (AB1207) every two years. The training can be obtained online at www.mandatedreporterca.com. LPA encouraged Director 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.

An exit interview was conducted. 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





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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Farhan Bashir-TariqTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/15/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/15/2021
LIC809 (FAS) - (06/04)
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