410500476-3-11-2022-05-CC-HLEG-CCF385-20220311170057

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410500476
Report Date: 03/11/2022
Date Signed: 03/11/2022 05:02:38 PM

Document Has Been Signed on 03/11/2022 05:02 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:	NUEVA SCHOOL, THE		FACILITY NUMBER:	410500476
ADMINISTRATOR:	EMILY KOLATCH		FACILITY TYPE:	850
ADDRESS:	6565 SKYLINE BLVD		TELEPHONE:	(650) 350-4523
CITY:	HILLSBOROUGH	STATE: CA	ZIP CODE:	94010
CAPACITY:	24	CENSUS: 14	DATE:	03/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	David Robinson and Megan Terra		TIME COMPLETED:	05:00 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 March 11, 2022, Licensing Program Analyst (LPAs), Leong and Van, conducted an unannounced annual random inspection with David Robinson and Megan Terra. The LPAs explained the inspection’s purpose to the director. All staff at the facility have fingerprint clearance through the Hillsborough School District. LPAs observed two teachers and one aide supervising fourteen children. The staff to children ratio was met. The Hours of operation are Monday to Friday, 8:00 a.m. to 3:00 p.m. LPAs and the Director inspected the facility for potential health and safety hazards. In all classrooms, toys, furniture, and learning materials are age appropriate. The furniture and play structures appeared to be in good shape. LPAs noticed that each child has a cubby labeled with their name. Per the director, the facility uses a rest mat during the child's nap time. If a child falls ill, the child will isolate in the nurse’s office until the parent arrives. All cleaning products, poisons, and other hazardous chemicals have been kept out of children's reach. The outdoor play structures are age-appropriate and well-kept. The facility has wood chips beneath the play structure to absorb accidental falls. The facility has no bodies of water on the premises, as well a carbon monoxide detector, a centralized smoke alarm, a fully charged fire extinguisher, and working telephones. According to the director, there are no firearms or weapons on premises. * 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: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

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: NUEVA SCHOOL, THE	FACILITY NUMBER: 410500476
	VISIT DATE: 03/11/2022

NARRATIVE

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LPAs observed that the facility had 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.) Children have access to drinking water via filter water. Children bring their own water bottles and lunches. All solid waste storage containers within the Center have a proper tight-fitting cover.

During the inspection, ten random children's records and personnel records were reviewed. The facility has a sign-in/out log with a piece of paper. A review of the facility's records revealed that the names, addresses, and phone numbers of each child's authorized representative are kept on file. In addition, each child's immunization record can be found in their file. A review of staff records revealed that multiple staff members have valid CPR and First Aid certifications. LPAs reviewed the director and teachers have the required ECE units. According to the Director, the Center simulates fires and earthquakes on a monthly basis.

LPA reminded the director each staff are required to complete a new mandated reporter certificate every two years. LPA reminded the director must complete the basic pest management annually.

Licensee 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.

*** See Page 3 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: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

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: NUEVA SCHOOL, THE	FACILITY NUMBER: 410500476
	VISIT DATE: 03/11/2022

NARRATIVE

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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/process.

LPAs 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.

During the inspection, LPA Van reviewed the new directors’ application. The application was in order and complete. LPA Van will update the new directors’ status once he arrives in the office.

The following license forms were obtained from the facility: LIC 610 and LIC 309

No deficiencies were cited today.

Exit interview conducted, and report reviewed with the new Director, David Robinson

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.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2022

LIC809 (FAS) - (06/04)

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