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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410503100
Report Date: 08/11/2020
Date Signed: 08/12/2020 11:11:40 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:PHILLIPS BROOKS NURSERY SCHOOLFACILITY NUMBER:
410503100
ADMINISTRATOR:THERIAULT, NICOLEFACILITY TYPE:
850
ADDRESS:2245 AVY AVE.TELEPHONE:
(650) 854-4545
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY:55CENSUS: 0DATE:
08/11/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Mr. Zac OldenburgTIME COMPLETED:
01:00 PM
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Licensing Program Analyst (LPA), Cindy Interiano conducted a Case Management inspection and met with Mr. Zac Oldenburg via a Tele-inspection. Purpose of the inspection was explained to Mr. Oldenburg. Facility currently operates in the Early Learning Center Building, in Rooms A (#2), Room B (#3), and Room C (#1).
Facility is requesting an increase of capacity from 55 Preschool age children to 70 Preschool children. An additional classroom #4 in the Main Office Building has been requested to be added to the License.
Mr. Oldenburg lead LPA on a virtually inspection of the facility indoors for Health and Safety Hazards. Per facility sketch,
> Classroom #4 measures 432 square feet, allowing for 12 PreK children.
Classroom has exclusive use of an accessible restroom in the building which has 1 toilet and 1 sink.
Based on facility sketch and virtual inspection, Facility has exclusive use of an extended portion of the ‘Upper Yard.’ Outdoor space was previously measured to be 7549.04 square feet. Based on Sketch, the extended portion of the ‘Upper Yard’ measures an additional 759.53 square feet. Total outdoor space measures 5308.57 square feet, allowing for 70 PreK children.
During inspection, LPA provided Technical Assistance for Covid-19 guidelines.
Mr. Oldenburg was advised that a follow-up inspection will be conducted in the future and measurement of indoor and outdoor space may be required.

Prior to Licensure,
>Fire clearance must be received.

Once Fire clearance has been received and request for increase of capacity has been reviewed by Management, License will be updated allowing capacity of 67 PreK children.
***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

>This report will be emailed to facility. This report must be available in the facility for public review. Any additional questions to call Office, M-F, 8a-5p, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/11/2020
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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