214005556-9-28-2021-05-CC-HRCO-C7ARMP-20210928130900

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 214005556
Report Date: 09/23/2021
Date Signed: 09/28/2021 01:10:23 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:	HORIZON COMMUNITY SCHOOL		FACILITY NUMBER:	214005556
ADMINISTRATOR:	EVANS, ANGELA		FACILITY TYPE:	850
ADDRESS:	200 PHILLIPS DRIVE		TELEPHONE:	(415) 324-7161
CITY:	MARIN CITY	STATE: CA	ZIP CODE:	94965
CAPACITY:	36	CENSUS: 0	DATE:	09/23/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:05 AM
MET WITH:	Angie Evans		TIME COMPLETED:	12:30 PM

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 Angie Evans, Associate Program Director of the facility on 9/23/21 for a pre-licensing inspection. The applicant has requested for a change of location and for a name change. The applicant has requested a combination of preschool program with toddler component program, 14 toddler ages 18 to 36 months, and 28 preschool children ages 2 to entry to Kindergarten. The facility will operate Monday - Friday; 7:30AM – 6:00PM. The facility is located on a functioning elementary school site of Sausalito Marin City School District. During today’s inspection, COVID-19 technical assistance, guidance, and support were provided. The facility was inspected today, indoor and outdoor, for health and safety hazards, and measured to calculate capacity. Indoor: There are 3 classrooms that will be used for the program, Room #107, Room #108 and Room #111. The following square footage was calculated for Room #107, 724. 623 sq. ft, allowing for a capacity of 20 children, Room #108, 709. 509 sq. ft, allowing for a capacity of 20 children, Room#111, 803.83 sq. ft, allowing for a capacity of 14 toddler children. The classroom’s furniture’s and equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. There is storage space for children's personal belongings located in the classroom. Mats will be utilized for napping children. Program will provide a sheet and blanket for the children. Bedding is to be washed weekly or as needed. Mats will be cleaned daily or as needed. The classroom is equipped with a fire extinguisher, smoke, and carbon monoxide detectors. The classroom is equipped with a working refrigerator. The classroom has garbage cans with tight-fitting lids. 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: 09/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021

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: HORIZON COMMUNITY SCHOOL	FACILITY NUMBER: 214005556
	VISIT DATE: 09/23/2021

NARRATIVE

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The classroom has a designated backpack with a first aid kit and emergency supplies. There is also a first aid kit located in each classroom. Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. The program will provide lunch and snacks daily for children.

Each classroom has 1 sink available for children to use. Room #111 has 1 toilet and a diaper changing table area with a sink within arms of reach. There are 2 toilets and 2 sinks available for Room #107 and Room #108 to use located on the other side of the building. The capacity for 2 toilets is 30, and the capacity for 2 sinks is 30. LPA reminded the Director that ratio and supervision must be observed at all times. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children. Isolation area for ill children is in the Director’s office, and staff bathrooms will be used for ill children. There are designated bathrooms for staff to use. Program will provide water for indoor and outdoor use. In addition, pitchers of water and disposable cups will be provided for indoor and outdoor use.

Outdoor: There are 2 playgrounds that will be used for the program. The playground area is separated into two playgrounds by a fence at least 4ft. tall. Playground #1 that will be used for the preschool program is shared with school-aged children of Sausalito Marin City School District and the following square footage is 1,701 sq. ft, allowing for a capacity of 22 children. Playground #2 that will be used for the toddler program (Room #111) and preschool children (Room #108) is shared with another program located in Sausalito Marin City School District. The square footage for playground #2 is 3,295 sq. ft, allowing for 43 children.

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: 09/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021

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: HORIZON COMMUNITY SCHOOL	FACILITY NUMBER: 214005556
	VISIT DATE: 09/23/2021

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The applicant has submitted an outdoor rotation waiver for Room #108 and Room #111. The applicant has obtained a letter from Sausalito Marin City School District for shared outdoor usage. The outdoor area was observed to be clean, safe, and equipped with toys that are age-appropriate for children. There is a tree in the playground that will be used for natural shade for children. Artificial turfs are used on the playground for cushion. Sheds for storage will remain closed and locked when children are present. LPA reminded Angie Evans to ensure ratio and supervision are observed at all times. The facility will conduct and log fire drills once every six months, and the log will be available upon request.

The following items were reviewed as part of today’s visit: Record keeping for staff, children, and facility records, care and supervision of the children, child discipline procedures – staff will use positive reinforcement and redirection. Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements.

This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

An electronic copy of this three-page report was emailed to Angie Evans. Applicant were asked to review the report and return a signed copy of the report to LPA Haydee Caliboso.

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of this facility for a maximum capacity of 42 children.

The following is required prior to regular licensure for a capacity of 42 children:
· Current Posting Requirements are posted
· Obtain approval from Marin County Fire Department

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650)266-8864
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/23/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2021

LIC809 (FAS) - (06/04)

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