380500240-1-18-2023-05-CC-CQUO-CN7U2P-20230118141212

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 380500240
Report Date: 01/18/2023
Date Signed: 01/18/2023 02:12:24 PM

Document Has Been Signed on 01/18/2023 02:12 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:	GLENRIDGE COOPERATIVE NURSERY SCHOOL		FACILITY NUMBER:	380500240
ADMINISTRATOR:	CAMPBELL, MARIELLEN		FACILITY TYPE:	850
ADDRESS:	GLEN PARK CANYON (CHENERY-ELK)		TELEPHONE:	(415) 586-2771
CITY:	SAN FRANCISCO	STATE: CA	ZIP CODE:	94131
CAPACITY:	25	CENSUS: 22	DATE:	01/18/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:45 AM
MET WITH:	Mariellen "Mame" Campbell		TIME COMPLETED:	02:15 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	On January 18, 2023 at approximately 11:45am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with director, Mariellen "Mame" Campbell, and explained the purpose of the inspection. The facility is located in Glen Canyon Park that operates in Park and Rec building. Facility is a co-op program that operates part time with a morning (9:30am to 12:30pm) and afternoon (12:30pm to 3:30pm) program. Present during inspection included director, two teachers, 5 volunteers/parents of enrolled children, and 22 enrolled children (preschool age). Facility is currently operating within teacher to child ratio during LPA's visit. With director, LPA inspected facility, indoors and outdoors, for health and safety hazards. Program's morning session operates on second floor of building with a capacity of 25 children. Program's afternoon session operates on ground level of building with a capacity of 19 children. Program does not currently provide a food service. Enrolled children's parents and/or authorized representatives provide children's meals. LPA observed both classrooms to be clean, equipped with age appropriate toys, materials and furniture. Classrooms are divided into separate sections that include a dramatic play, arts and crafts, journal, quiet time and multipurpose areas. Storage for children's belongings are located either inside or outside the classrooms, labeled with each child's individual names. Both classrooms are equipped with fully charged fire extinguishers and working carbon monoxide detectors. LPA observed poisons, cleaning supplies and other hazardous materials inaccessible in classroom's high shelves, off limit areas, and/or locked in storage rooms. Each classroom is equipped with an emergency backpack that contains emergency information, first aid kits and emergency medication. Bathrooms are located on the first floor of the building. LPA observed bathrooms to be in proper working condition equipped with appropriate sanitation products. Second floor of building also includes a kitchen that is made inaccessible to enrolled children. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023

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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STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GLENRIDGE COOPERATIVE NURSERY SCHOOL	FACILITY NUMBER: 380500240
	VISIT DATE: 01/18/2023

NARRATIVE

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Outdoor area includes an open space in front of facility building and balcony attached to building. There is a variety of outdoor equipment that was observed to be in good working condition. LPA observed facility maintains outdoor waiver. Facility has license documentation and information properly posted and available for review. Children are signed in and out of facility by parents' written signatures.

LPA reviewed facility records that included 5 children's records, sample of volunteers/parents records and 4 staff records. LPA observed children's and staff's records to be complete. Staff have completed and current Mandated Reporter and CPR/First Aid certifications. Staff also have proof of required immunizations that were made available for review. Records of parent volunteers also provide proof of required immunizations.

Director's CPR and First Aid certificate is current and will expire September 2023. Last emergency drill was conducted 10/25/2022. Emergency drills are conducted at least once every 6 months and are properly logged and documented.

Facility was informed 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 is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.
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SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: GLENRIDGE COOPERATIVE NURSERY SCHOOL	FACILITY NUMBER: 380500240
	VISIT DATE: 01/18/2023

NARRATIVE

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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.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. 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

No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with director, Mariellen "Mame" Campbell.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/18/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/18/2023

LIC809 (FAS) - (06/04)

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