410501179-10-9-2019-05-CC-CINO-BGSPU2-20191009113648

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410501179
Report Date: 10/09/2019
Date Signed: 10/09/2019 11:36:56 AM

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:	ROBERTS SCHOOL, INC., THE		FACILITY NUMBER:	410501179
ADMINISTRATOR:	ELISA BARRETT		FACILITY TYPE:	850
ADDRESS:	641 COLEMAN AVE		TELEPHONE:	(650) 322-3535
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY:	50	CENSUS: 36	DATE:	10/09/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:20 AM
MET WITH:	Director, Elisa Barrett		TIME COMPLETED:	11:50 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), Cindy Interiano conducted an Annual/Random inspection and met with Director, Elisa Barrett. Purpose of the inspection was explained to the Director. Program operates 4 classrooms: Front Building: Rainbow, Bumblebees, Dinosaurs, and Back Building: Dragon. Program operates M-F, 7:30a-6p, year-round with periodic breaks throughout the year. Present during the inspection was Director and 5 Staff supervising 36 PreK children. Program is in compliance with staff:child ratios. LPA and Director inspected facility indoors and outdoors for Health and Safety Hazards. Classrooms have age appropriate toys and equipment. Cubbies, hooks, and bins are used to store children’s belongings. Classrooms have/share restrooms: In the front building: there are two restrooms, each with 2 toilets, a changing table, and 1 sink; In the back building: there is a restroom with 1 toilet and 1 sink. Additional sinks are in the classrooms. Restrooms are kept clean, in good repair, and maintained with adequate supplies. Staff use separate restrooms, which are maintained ‘off limits’ to children. Program provides snacks and children bring their own meals. Facility has a fully supplied Emergency Kit and Emergency supplies, which are maintained inaccessible to children. Medications are maintained in the kitchen, and is kept with Guardian consent form, Doctor’s prescription and a log (when administered). Classroom has multiple smoke and carbon monoxide detectors, and fully charged Fire Extinguishers. Last Emergency Disaster drill was conducted on 09/23/19 and is properly logged. Discipline policy is mainly redirection. Napping equipment is properly stored. Facility has three outdoor play areas, separated by a fence: Sand yard, Grass yard, and Bark yard. Outdoor play area is kept clean and free of debris and hazardous items. Staff conduct a daily sweep prior to the children going out for outdoor play. All outdoor toys and equipment are age appropriate and in good repair. Drinking water is readily available outdoors and indoors. All mandatory postings are posted in the kitchen area. Sign in out sheets were reviewed and are complete and up-to-date. Staff and children’s files were reviewed and are complete and up-to-date. All staff have required immunization and current CPR card on file. See Page 2. . .

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

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 2

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: ROBERTS SCHOOL, INC., THE	FACILITY NUMBER: 410501179
	VISIT DATE: 10/09/2019

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. . .

Discussed during the inspection was a pending criminal record clearance status Staff #1. Director states Staff #1 no longer works at the facility. Director knows and understands Staff #1 cannot be present in the Facility during daycare hours, unless Staff#1 gets an exemption approval from CCLD.

Also during the inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Director was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare.
*Director was reminded about Mandated Reporter Training available on CCLD website
(www.ccld.ca.gov or www.mandatedreporterca.com)
*Director was advised of the new Lead Bill (effective 01/01/19), requiring Facilities to distribute a two-page flyer to Guardians with information on lead poisoning facts
*Director was reminded about the Provider Information Notices (PINs) on CCLD website.

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

>This report and rights to comment and appeal were discussed with Director. This report must be available in the facility for public review. Notice of site inspection was posted.
Director was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/09/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/09/2019

LIC809 (FAS) - (06/04)

Page: 2 of 2