213005258-9-24-2019-05-CC-LGOZ-BGBVRJ-20190924164001

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 213005258
Report Date: 09/24/2019
Date Signed: 09/24/2019 04:40:25 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:	MARIN DAY SCHOOLS - PARK SCHOOL CAMPUS EDS		FACILITY NUMBER:	213005258
ADMINISTRATOR:	PATRICIA WOODS		FACILITY TYPE:	840
ADDRESS:	360 EAST BLITHDALE AVENUE		TELEPHONE:	(415) 388-1458
CITY:	MILL VALLEY	STATE: CA	ZIP CODE:	94941
CAPACITY:	36	CENSUS: 12	DATE:	09/24/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Director, Patricia Woods		TIME COMPLETED:	04:45 PM

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Licensing Program Analyst, (LPA) Luis J. Gomez met with Director, Patricia Woods. The purpose of the visit was explained and is for an unannounced annual inspection. The is an After-school program, which operates during the school year at the Park School Campus. The program utilizes 1 classroom (Room #15) and 1 outdoor play area. Hours of operation are Monday- Friday 1:30pm- 6:30pm. Present is the director and 2 staff supervising 12 children. Facility is within capacity limits of the license. LPA toured facility with the director and inspected for health and safety hazards.

2:35 pm on September 24, 2019 LPA Gomez inspected classroom, bathrooms and outdoor play area for hazards and dangerous conditions. Classroom is equipped with a carpet area, books, board games and art supplies for the children. Classrooms has a carpet and child size tables and chairs for class projects. Classroom has plenty of storage cabinets and a refrigerator. Classroom has acceptable ventilation and natural lighting. LPA observed all food for snack is properly labeled with expiration dates. Classroom is equipped with working smoke detector, carbon monoxide detector and fully charged fire extinguisher (3A40BC). A first aid kit is readily available and an emergency disaster supplies are maintained in the back closet and inaccessible to children. At 2:42pm on September August 24, 2019 LPA observed a trolley in the boy’s bathroom. LPA observed the outdoor play area has a large climbing structure and benches in the shade. Structure and equipment are in good repair. Outdoor play area is free of debris or health and safety hazards. Drinking water is readily available indoors and outdoors children with use of water fountains.

3:20pm on September 24, 2019 LPA reviewed a sample of children’s files and facility roster during today’s inspection. Facility files are complete and current. Director's CPR/ 1^st aid is current expiring: October 14, 2020.

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SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

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: MARIN DAY SCHOOLS - PARK SCHOOL CAMPUS EDS	FACILITY NUMBER: 213005258
	VISIT DATE: 09/24/2019

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Director stated that the program provides daily snacks for the children. Emergency drills are done monthly, with the last drill conducted on May, 2019, properly logged. LPA Gomez observed all required licensing information is properly posted in the classroom.

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

Director, Patricia Woods was reminded that as of September 1, 2016, a person may not be employed or volunteer at a child care 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 Patricia Woods was informed about the Provider Information Notices (PINs) on CCLD website.

Based on today's inspection, no deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Ca. Code of Regulations. Exit interview was conducted with Patricia Woods, and her signature of this form acknowledges receipt of these documents.

>This report and rights to comment and appeal were discussed with Site Supervisor. This report must be available in the facility for public review. Notice of site inspection was posted.
Site Supervisor was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8832
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 393-9134
LICENSING EVALUATOR SIGNATURE:	DATE: 09/24/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/24/2019

LIC809 (FAS) - (06/04)

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