214005192-8-31-2022-05-CC-HLEG-CHTRHH-20220831130221

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005192
Report Date: 08/31/2022
Date Signed: 08/31/2022 01:02:29 PM

Document Has Been Signed on 08/31/2022 01:02 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	C.A.M. (CFS) -CANAL CHILD CARE CENTER (PS)		FACILITY NUMBER:	214005192
ADMINISTRATOR:	LOMBARDI, KELSEY		FACILITY TYPE:	850
ADDRESS:	215 MISSION AVENUE		TELEPHONE:	(415) 457-4036
CITY:	SAN RAFAEL	STATE: CA	ZIP CODE:	94901
CAPACITY:	44	CENSUS: 11	DATE:	08/31/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:10 AM
MET WITH:	Alida Leon		TIME COMPLETED:	01:02 PM

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On 8/31/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the C.A.M Preschool facility. The LPA was granted entry by the Director, Alida Leon. The LPA explained the purpose of the visit to the director. All facility’s staff members have had their criminal background checks cleared by Guardian. The LPA observed three teachers and two helpers supervising eleven preschool children. Children's capacity and ratio requirements were observed to be in compliance,

Both LPA and the director thoroughly checked the facility for potential health and safety hazards. The facility has a first aid kit that is fully stocked with all of the necessary supplies for treating injuries. Toys, furniture, and learning materials are all age appropriate in all classrooms. The LPA observed that the outside furniture and play structures are in excellent condition. Wood chips surround the outdoor play structures, absorbing any accidental falls. Resting mats and cots are provided for children to use while napping. The LPA observed that there were no bodies of water at the facility. All cleaning products, poisons, and other hazardous chemicals have been kept out of reach of children. The facility has smoke detectors, carbon monoxide detectors, fully charged fire extinguishers, centralized smoke alarms, and working phones. According to the director, there are no firearms or weapons in the facility.

The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

The LPA reviewed the records of eleven children. All required forms were in the children’s’ file. The program uses a sign in / out sheet for authorized individuals to sign their children in and out.

The LPA reviewed the records of six staff members. All required forms were in the staff files. A review of staff records revealed that one staff member is currently certified in CPR and First Aid.

***See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

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: C.A.M. (CFS) -CANAL CHILD CARE CENTER (PS)	FACILITY NUMBER: 214005192
	VISIT DATE: 08/31/2022

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According to the director, the Preschool simulates fire and earthquake drills once a month.

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.

Incidental Medical Services (IMS) policy was discussed with the director. 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 the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The LPA encouraged the director to frequently visit the Licensing 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.

A copy of this report, and the “Notice of Site Visit” were given to the director.

A Notice of Site Visit must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Director, Alida Leon

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2022

LIC809 (FAS) - (06/04)

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