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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410500410
Report Date: 12/19/2019
Date Signed: 12/19/2019 01:10:20 PM

COMPREHENSIVE INSPECTION
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:MERRY MOPPET NURSERY SCHOOLFACILITY NUMBER:
410500410
ADMINISTRATOR:KHOURY, JENNIFERFACILITY TYPE:
850
ADDRESS:2200 CARLMONT DRIVETELEPHONE:
(650) 593-6175
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY:237CENSUS: 125DATE:
12/19/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
09:25 AM
MET WITH:Jennifer KhouryTIME COMPLETED:
01:30 PM
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Licensing Program Analyst (LPA) April Cowan met with Site Director for an unannounced annual random inspection. Present today is 145 Preschoolers, 20 teachers, and the site director. Staff to child ratio was met on this day. The center operates Monday - Friday 7:00am to 6:00pm. The center has 8 classrooms 2,3,4,5,A, B, C, and G.
LPA and Site Director inspected the day care areas. The center is clean, orderly and in good repair. There are no pools, spas or other similar bodies of water on site. Per director, there are no firearms nor weapons on site. Cleaning supplies and other potentially harmful items are stored inaccessible to the children. All furniture and equipment is clean and in good working condition. The center's furniture and equipment is age appropriate, and there is a sufficient quantity of tables and chairs to meet the capacity. Cots are stored properly. Per director, cots and bedding are washed and cleaned weekly. Facility supplies lunch and two snacks daily. Monthly menus are posted in each classroom at least one week in advance. The center has working carbon monoxide/fire detectors in each classroom. All solid waste storage containers have secure lids. Facility's last emergency drill was conducted 12/18/19 and is properly logged. Per director, emergency drills are conducted monthly.
See next page for continuation......
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: MERRY MOPPET NURSERY SCHOOL
FACILITY NUMBER: 410500410
VISIT DATE: 12/19/2019
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Emergency supplies are available and maintained. First Aid Kit is properly maintained and kept inaccessible to children. LPA discussed with director that at least one person that has been trained in CPR and Pediatric First Aid must be always present at the facility or at off-site activities. Facility has appropriate postings. At 10:15, sign in/out sheets were reviewed where LPA observed full signatures of parents. The outdoor play area is clean and in good repair. All toys and equipment are in working condition. Areas under slides and other high climbing equipment is adequately cushioned with pour 'n' play padding.
At 10:37 AM, 10 staff files were reviewed. Staff files are complete with all necessary licensing forms. Education units are on file for teaching staff. At least one staff member on site has current CPR/First Aid certification.
At 11:30, children's files were reviewed. Children's files are complete with all required documents.
Incidental Medical Services (IMS) policy was discussed. Director submitted to LPA the IMS Plan, LIC 308 Designation of Facility Responsibility, and Facility Roster for Facility.
Director was informed, as of January 1, 2018 all staff will be required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: MERRY MOPPET NURSERY SCHOOL
FACILITY NUMBER: 410500410
VISIT DATE: 12/19/2019
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>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

This report must be available in the facility for public review. Notice of site visit was observed being posted. Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 12/19/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/19/2019
LIC809 (FAS) - (06/04)
Page: 3 of 3