410500602-3-2-2022-05-CC-BVAN-CC5SJS-20220302125538

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410500602
Report Date: 03/02/2022
Date Signed: 03/02/2022 12:58:36 PM

Document Has Been Signed on 03/02/2022 12:58 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:	ST. PAUL'S NURSERY SCHOOL		FACILITY NUMBER:	410500602
ADMINISTRATOR:	WILLIAMSON, LISA		FACILITY TYPE:	850
ADDRESS:	405 EL CAMINO REAL		TELEPHONE:	(650) 344-5409
CITY:	BURLINGAME	STATE: CA	ZIP CODE:	94010
CAPACITY:	50	CENSUS: 31	DATE:	03/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:35 AM
MET WITH:	Lisa Williamson		TIME COMPLETED:	01:00 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 2, 2022, Licensing Program Analyst (LPA) Van met with the new Director, Lisa Williamson, for an unannounced annual random inspection. The purpose of the inspection was explained and granted entry to the facility by the Director. The facility is a Preschool Cooperative. There are six staff and four co-op parents supervising 31 children. The days and operations hours are Monday - Friday from 9:00 am to 12:00 pm. There is an option for lunch on Monday and Thursday from 12:00 pm to 1:00 pm for the Junior classroom. There is extended hours for the senior classroom children until 1:45 pm on Monday - Thursday. The program operates in 8 classrooms. They are the 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. The isolation area for an ill child is one of the empty classrooms, and the staff will monitor and supervise the child while parents are contacted to come and pick up the child. LPA and the Director inspected the facility for health and safety hazards. All classrooms have age-appropriate toys and learning materials. Furniture appears steady and in good repair. The facility has multiple carbon monoxide detectors, a centralized smoke alarm, multiple fully charged fire extinguishers, and working telephones. LPA observed that each child has their cubbies available with their name labeled. All emergency supplies are stored in locked storage. Medications are appropriately labeled and stored out of reach of children. First aid supplies are available. Children's toilets and sinks are in good working condition with proper sanitation. The staff has a separate bathroom. All cleaning solutions, poisons, and other dangerous chemicals have been stored in an area inaccessible to children. Outdoor play structures are age-appropriate and in good condition. There are wood barks/chips underneath all play structures to absorb accidental falls. LPA observed no bodies of water on the premises.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/23/2022

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: ST. PAUL'S NURSERY SCHOOL	FACILITY NUMBER: 410500602
	VISIT DATE: 03/02/2022

NARRATIVE

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LPA observed that the facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, Emergency Disaster Plan, and Daily activities). Snack is provided to children. A menu is reviewed and is posted today. The food preparation area is adequately equipped, clean, and free of hazards; this area is made inaccessible to children in care, but it is used as a passageway to go to the outdoor play area. Drinking water is accessible by drinking faucets/water filters and water pitchers in each classroom. LPA reminded All storage containers for solid waste within the Center have a proper tight-fitting cover.

Ten random children's records and all personnel records were reviewed during the inspection. The facility stored the children's records online through Jovial, and parents' sign-in/out are electronically, and Jovial maintains both. All records are available to print out when required by Licensing. Records review showed the facility has records of each child's authorized representative's names, addresses, and telephone numbers. In addition, each child's immunization record can be located in each child's file. Staff records review showed multiple staff members have a record of valid CPR in file and immunization on their respective file. LPA reviewed the educational qualification of all the teachers, and all teachers had the required ECE units. All co-op parents have TB clearances on their respective files. The Director stated that the Center is conducting fire and earthquakes quarterly. The last drill was conducted on 11/20/2021.

The Director 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

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: ST. PAUL'S NURSERY SCHOOL	FACILITY NUMBER: 410500602
	VISIT DATE: 03/02/2022

NARRATIVE

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The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPA encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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.

The following document was requested, and the facility has until March 11, 2022.

IMS Plan (Incidental Medical Services)

No deficiencies are cited today. An exit interview was conducted, and the report was reviewed with the Director, Lisa William. Today's report, March 2, 2022, and notice of site visit will be sent to the Director by email by the close of business on March 2, 2022. Confirmation of receipt is required. LPA informed the Director that the notice of site visit must be posted for 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2022

LIC809 (FAS) - (06/04)

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