410500602-2-11-2020-05-CC-BVAN-BLPQZ3-20200211113605

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410500602
Report Date: 02/11/2020
Date Signed: 02/11/2020 11:36:16 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:	ST. PAUL'S NURSERY SCHOOL		FACILITY NUMBER:	410500602
ADMINISTRATOR:	CAJBON, MARISA		FACILITY TYPE:	850
ADDRESS:	405 EL CAMINO REAL		TELEPHONE:	(650) 344-5409
CITY:	BURLINGAME	STATE: CA	ZIP CODE:	94010
CAPACITY:	50	CENSUS: 33	DATE:	02/11/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:40 AM
MET WITH:	Marisa Cajbon		TIME COMPLETED:	11:45 AM

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 Analyst (LPA) Van met with the Director, Marisa Cajbon, for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. Present, there are 4 teachers and several parents supervising 33 children. The facility is a Preschool Cooperative and operates on Monday - Friday from 9:00 AM to 12:00 PM. There is an option for a lunch on Monday and Tuesday from 12:00 PM to 1:00 PM, and from Monday to Thursday, there is a second seniors group from 10:45 AM to 1:45 PM. The program operates in 8 classrooms for children; Block room, Senior room, Dress-up room, Creation Station, Discovery room, Art room, Junior room, and the room designated on the facility sketch as Parent's break room (which is used for cooking projects and other special activities) LPA, along with the Director, inspected the facility for health and safety hazards. The facility is in good repair and free of any hazards with proper temperature and ventilation. A variety of age-appropriate toys and learning materials for children are available in the classroom. LPA observed no pools, spas, or other bodies of water at the facility. The facility has a smoke detector, fully charged fire extinguishers, and a working telephone at the facility. All cleaning solutions, poisons, and other chemicals that are dangerous stored inaccessible to children. Per the Director, sick children will be separated from the group and will be situated on the bench with the staff on the front porch for parents to pick up. Per the Director, the center provides a morning snack. All the bathrooms, toilets, and sinks are clean and well sanitized. There is a total of 3 toilets and 2 sinks. There is a separate bathroom available to staff. The facility has a water fountain readily available for children to use outdoor and water filter pitchers indoor. The outside play area is completely fenced, clean, and in good repair. The playground is free of hazardous materials, and the play equipment is age-appropriate and safe. Climbing structures are securely anchored, free of any loose parts, and have sufficient amounts of cushioning floor to prevent any fall injuries. Per the Director, the sandbox is inspected daily. LPA did not observe any bodies of water in the outdoor area.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020

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: ST. PAUL'S NURSERY SCHOOL	FACILITY NUMBER: 410500602
	VISIT DATE: 02/11/2020

NARRATIVE

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In today’s inspection, LPA randomly reviewed the staff and children's records, Care and Supervision of the Children, Medication Policies, Isolation of Sick Children, and Reporting Requirements. LPA observed that the facility has a sign-in/out record for the parent or authorized representative. A review of staff records during today’s visit indicates that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. All staff have a record of valid Pediatric FirstAid/CPR card in file. Also, all staff have the required immunization and verification of the mandated child abuse reporting training as compliant with AB1207. LPA also observed that the facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, and Emergency Disaster Plan). The Director stated that Fire and Earthquake drills are conducted every six months.

LPA reminded the lead teacher that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles.

LPA reviewed AB 1207 with the lead teacher. 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.

ADA information was provided; US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication. Pesticides training was also discussed (Information on the DPR website at www.cdpr.ca.gov/shoolipm/childcare). Incidental Medical Services (IMS) Plan was also discussed with the Director.

LPA also went over the Child Care Center checklist and provided a copy to the lead teacher during the inspection for reference in the future inspection.

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 the next 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/11/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/11/2020

LIC809 (FAS) - (06/04)

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