410500506-5-14-2024-05-CC-MOLN-D59QME-20240514121724

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410500506
Report Date: 05/14/2024
Date Signed: 05/14/2024 12:17:36 PM

Document Has Been Signed on 05/14/2024 12:17 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PENINSULA COVENANT PRESCHOOL		FACILITY NUMBER:	410500506
ADMINISTRATOR/ DIRECTOR:	CORRALES, JENNIFER		FACILITY TYPE:	850
ADDRESS:	3560 FARM HILL BLVD		TELEPHONE:	(650) 365-8079
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY: 55	TOTAL ENROLLED CHILDREN: 20	CENSUS: 15	DATE:	05/14/2024
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:15 AM
MET WITH:	Jennifer Corrales		TIME VISIT/ INSPECTION 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	On Mary 14, 2024, at approx. 9:25am Licensing Program Analyst (LPA) Maria Olguin-Leon met with Director Jennifer Corrales for an unannounced annual inspection visit. Purpose of inspection was explained. Present today, Director, 4 staff and 15 children. Facility is operating within capacity and in compliance with staff/child ratio. All staff have criminal background clearances. Facility operates preschool program from Monday to Friday 9:00am to 1:00pm and closed during summers. Facility follows the school year calendar. LPA and Director toured the facility for health and safety hazards. Facility is licensed in six classroom and currently only utilizing three classroom, #4, #5, and #6 which is used as a lunchroom for children. Facility is clean with proper temperature and ventilation. There are plenty of age-appropriate toys, furniture, learning materials and art supplies. Portable storage cubbies are used for children to store personal items and belonging. There are two separate bathrooms for children; toilets are in working condition and there is no hot running water in sinks. There is a separate staff bathroom. All trash cans are equipped with tight fitting lids. All cleaning products, chemicals and toxins are stored and locked in cabinet and inaccessible to children. Children do not nap at facility. Playground is located in lower part of facility and is accessible across walking bridge. Playground is equipped with a large age-appropriate play structure, sensory water/sand table and tables, all in good condition. There is a locked storage shed with first aid box and outdoor toys. Playground is surrounded with a 5 ft. fence. Flooring under play structure is equipped with sand to cushion fall. And remainder of flooring is asphalt. LPA did not observe any pools, spas, or bodies of water. Per Director, there are no weapons or firearms on the premises. Children bring their own snacks and lunches from home. Children bring their own labeled water bottles from home and are refilled with water pitchers located in each classroom. First aid kit is fully stocked with medical supplies. Incidental Medical Services were discussed. Sick children are isolated in office and away from other children. Cont. page 2...

Marie Rodriguez
Maria Olguin-Leon
	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

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 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: PENINSULA COVENANT PRESCHOOL	FACILITY NUMBER: 410500506
	VISIT DATE: 05/14/2024

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
26
27
28
29
30
31
32

Page 2...

Facility uses sign in and sign out sheets. LPA reminded Director to have parents sign with full signatures. Facility is equipped with fully charged fire extinguishers, working carbon monoxide detector, and working smoke detectors. Last emergency drill was conducted on 03/13/2024 and properly documented. Facility has a landline and uses cell phone for communication with staff.

LPA reviewed 5 children’s records 5 staff record. All the children's were complete. The facility has all necessary paperwork posted, Facility License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan.

Incidental Medical Services (IMS) policy was discussed. For IMS information see PIN 22-02- CCP. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Cont. page 3...

SUPERVISOR'S NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 6 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: PENINSULA COVENANT PRESCHOOL	FACILITY NUMBER: 410500506
	VISIT DATE: 05/14/2024

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
26
27
28
29
30
31
32

Page 3...

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, 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 for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

LPA referred Director to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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 encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Cont. page 4...

SUPERVISOR'S NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 5 of 6

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: PENINSULA COVENANT PRESCHOOL	FACILITY NUMBER: 410500506
	VISIT DATE: 05/14/2024

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
26
27
28
29
30
31
32

Page 4...

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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

Type B violation is being cited on this day in accordance with the California Health & Safety Code, see LIC 809D.

A notice of site visit was given and must remain posted for 30 days. LPA provided Appeal rights.

Exit interview conducted and report was reviewed with Director, Jennifer Corrales.

SUPERVISOR'S NAME: Marie Rodriguez
LICENSING EVALUATOR NAME: Maria Olguin-Leon
LICENSING EVALUATOR SIGNATURE:	DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 4 of 6

Document Has Been Signed on 05/14/2024 12:17 PM - It Cannot Be Edited

Created By: Maria Olguin-Leon On 05/14/2024 at 12:09 PM

Link to Parent Document Below:

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

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

FACILITY NAME: PENINSULA COVENANT PRESCHOOL	FACILITY NUMBER: 410500506
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/14/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based upon record review, the facility has not test for lead. This posed a potential health, safety, or personal rights risk to the persons in care.
	POC Due Date: 06/14/2024
	Plan of Correction
1 2 3 4	Per Director, Director is currently working on lead testing and will have lead tested soon.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME:

Marie Rodriguez

LICENSING EVALUATOR NAME:

Maria Olguin-Leon

LICENSING EVALUATOR SIGNATURE:

DATE: 05/14/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/14/2024

LIC809 (FAS) - (06/04)

Page: 2 of 6