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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 214005350
Report Date: 02/06/2023
Date Signed: 02/06/2023 02:59:17 PM


Document Has Been Signed on 02/06/2023 02:59 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:CATERPILLAR ACADEMY (INF)FACILITY NUMBER:
214005350
ADMINISTRATOR:MARION ROLLINSFACILITY TYPE:
830
ADDRESS:1569 SIR FRANCIS DRAKE BLVD.TELEPHONE:
(415) 456-4478
CITY:FAIRFAXSTATE: CAZIP CODE:
94930
CAPACITY:18CENSUS: 18DATE:
02/06/2023
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:43 PM
MET WITH:Marion RollinsTIME COMPLETED:
02:44 PM
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On February 6, 2023, Licensing Program Analyst (LPA) Sheran Lo met with applicant Marion Rollins for a scheduled Increase Capacity inspection. The applicant is requesting 24 children (ages 0 to two years old). The facility will operate Monday-Friday; 8:00 AM to 5:00PM. The facility was inspected today, indoor for health and safety hazards and measured to calculate capacity.

Indoor: There are 5 sections that will be used for the program and the following square footage was calculated for the space. Total useable indoor square footage is 847.92 sq ft divided by 35 sq ft equals 24 children. The indoor space for children is observed today to be clean. There are 2 toilets (30 capacity) and 2 sinks (30 capacity) accessible for children’s use. Bathrooms are located next to the room. The bathrooms were observed to be clean and no health and safety hazards. Sinks accessible to children deliver water that is no warmer than 120 degrees.

LPA Lo will recommend licensure of this facility for a capacity of 24 children once the following is received:



-FIRE CLEARANCE (STD 850)
SUPERVISOR'S NAME: Daniel J OquendoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Sheran LoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/06/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/06/2023
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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