410500506-10-3-2019-05-CC-HKAR-BGLPYE-20191003114348

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410500506
Report Date: 10/03/2019
Date Signed: 10/03/2019 11:44:05 AM

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:	PENINSULA COVENANT PRESCHOOL		FACILITY NUMBER:	410500506
ADMINISTRATOR:	RHOADS, KELLEY		FACILITY TYPE:	850
ADDRESS:	3560 FARM HILL BLVD		TELEPHONE:	(650) 365-8079
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	55	CENSUS: 32	DATE:	10/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Maria Kirksey & Kelly Rhoads		TIME COMPLETED:	12:00 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	Licensing Program Analysts (LPAs) Kaur and Singh met with teacher Maria Kirksey, for a random annual inspection. Purpose of the inspection was explained. Director arrived at the facility during the inspection. Present, there are 32 children with seven teachers. Facility is operating within the capacity and in compliance with staff child ratio on this day. Facility operates day care from Monday to Friday between 08:30 AM to 01:30 PM, September to May. Facility is closed for summer. With teacher, LPAs inspected the day care classrooms 1,2,4,5,6 and play yard. Facility is not using classroom 3 at this time. There are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors and fully charged fire extinguishers on site. Facility has working telephone at the site. All the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored in high cabinets and are inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. All toilets, hand washing facilities are in working condition with proper sanitation in place. Facility has drinking water available for children. Facility has first aid supplies available at the office. Per teacher, facility only provides snacks, and snacks are stored in pantry in office. LPAs observed the food being stored in sealed bags or containers. All of the unused electrical outlets have child protective covers installed. See next page for continuation .............

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

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: PENINSULA COVENANT PRESCHOOL	FACILITY NUMBER: 410500506
	VISIT DATE: 10/03/2019

NARRATIVE

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Continuation from previous page ..........

All the play structures are steady, in good repair and free of any loose parts. There is sufficient amount of wooden chips under the play structures to prevent any fall injuries. There is drinking water in play yard for children. LPAs observed two sand boxes in the play yard, Per director, play yard is being inspected every day in the morning before being used by the children. There is sufficient amount of shaded area available for children to use.

At 10:30 AM, LPAs reviewed the facility records. LPAs observed that facility has sign in / out record with full legal signatures. Facility has all of the required documents posted and visible for the public. LPAs reviewed eight random children's and all staff's files. LPAs observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility has record of immunization of each child attending child care. LPAs observed facility has record of staff’s immunization on file. LPAs reviewed the educational qualification of all the teachers.Director is aware that as of January 1, 2018 all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPAs observed the completion certificates on file.

LPAs discussed the effects of lead exposure with the director and a handout was provided. LPA encourages the director to frequently visit our 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.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/03/2019

LIC809 (FAS) - (06/04)

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