410503442-10-18-2019-05-CC-HKAR-BH3P7M-20191018110409

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410503442
Report Date: 10/18/2019
Date Signed: 10/18/2019 11:04:21 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:	VILLAGE NURSERY SCHOOL		FACILITY NUMBER:	410503442
ADMINISTRATOR:	DONDOY, ROXANNE		FACILITY TYPE:	850
ADDRESS:	474 N PARKVIEW AVENUE		TELEPHONE:	(650) 992-4350
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94014
CAPACITY:	24	CENSUS: 19	DATE:	10/18/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Roxanne Dondoy		TIME COMPLETED:	11:30 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)Kaur and (LPM) Ali Zebila met with Director, Roxanne Dondoy, for a random annual inspection. Purpose of the inspection was explained to her. Present, there are 19 children with 2 teachers and 5 parents as a volunteer. Facility is operating within the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 08:00 AM to 06:00 PM, With director, LPA inspected the day care classrooms and play yard. LPA observed children were engage in a group with different activity. There are no pools, spas or other bodies of water at the facility. Facility has multiple smoke detectors, carbon monoxide detectors and fully charged fire extinguishers on site. Facility has working telephone at the site. Per director, there are no firearms or weapons at the center. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored in high cabinets and are inaccessible to the children. Facility has age appropriate furniture. Furniture is in good repair. All toilets, and hand washing facilities are in working condition with proper sanitation in place. The hot water was turned off in the children’s restrooms. Children take their water bottle in play yard and facility has drinking water available for children. Facility has first aid supplies available and were inspected. Per director, facility only provides snacks, but no meals. Children bring their own lunch. All of the unused electrical outlets have child protective covers installed. Play yard is free of hazards. All of the play structures are steady, and in good repair and free of any loose parts. There is enough wooden chips/ cushioning material under the play structures. The outdoor play area was completely fenced. There is sufficient amount of shaded areas available for the children. Documentation of emergency drills was logged and conducted once every six months. The latest drill was conducted in 08/26/19. Per director, there was no child on special medication. Incidental Medical Services (IMS) policy was discussed. See next page for continuation .............

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

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: VILLAGE NURSERY SCHOOL	FACILITY NUMBER: 410503442
	VISIT DATE: 10/18/2019

NARRATIVE

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At 10 AM, LPAs reviewed the facility records. LPA observed that facility has electronic sign in / out . Facility has all of the required documents posted and visible for the public. LPA reviewed 10 random children's and all staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility has record of immunization of each child attending child care. LPA also obtained a copy of the roster from licensee during inspection. LPAs observed facility has record of staff’s immunization on file. Director has valid CPR card on file expires on 03/17/ 20. LPA reviewed the educational qualification of all teachers.

LPAs reviewed AB 1207 with the director. Director is aware that 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.

LPAs discussed the effects of lead exposure with the director and a handout was provided. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

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 next 30 days.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/18/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/18/2019

LIC809 (FAS) - (06/04)

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