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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410503906
Report Date: 11/14/2019
Date Signed: 11/14/2019 12:31:00 PM

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:CHILDRENS PLACE, THEFACILITY NUMBER:
410503906
ADMINISTRATOR:RINALDI, LISAFACILITY TYPE:
850
ADDRESS:1336 ARROYO AVENUETELEPHONE:
(650) 595-1910
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY:36CENSUS: 32DATE:
11/14/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Lisa RinaldiTIME COMPLETED:
12:45 PM
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On 11/14/19 at 8:40 am, Licensing Program Analyst (LPA) April Cowan met with director, Lisa Rinaldi, for a random annual inspection. The purpose of the inspection was explained. Present in the facility are Director, 5 staff, and 32 Preschoolers. Facility is operating within capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday from 7:00 AM to 6:00 PM.

With director, LPA inspected the day care rooms and play yard. LPA observed facility has working smoke detector, carbon monoxide detector, 2 fully charged fire extinguisher and working telephone on site. All cleaning solutions, poisons and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility is floor is in good repair and free of any hazards. There is first aid supplies available in each classroom. All hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste are in good repair and have proper lids. All food is stored in a properly manner and has lids to avoid contamination. Facility provides 2 snacks per day. Parents provide lunch for children and lunches are kept in labeled cubby for each child. Play yard is free of hazards. There is sufficient cushion material in the play yard to help absorb the impact of falls.
There is one temporary staff, Barbara Wilk, who is not on Facility Fingerprint List. Director presented proof of submission of faxed LIC9182 on 11/12/19 at 9:34 PM.
See next page for continuation .........
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
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: CHILDRENS PLACE, THE
FACILITY NUMBER: 410503906
VISIT DATE: 11/14/2019
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Continuation from previous page .............

At 11:32 AM, LPA reviewed the facility records. LPA observer staff files are complete with all reqired documents. LPA observed that all children's files are complete with all required documents. LPA observed that facility is using electronic sign in/out. LPA acquired a copy of the sign in/our form for this day. LPA acquired a copy of facility roster for file. Facility has license and all other required documents posted and visible for the public view (Personal Rights, Parents Rights Poster, Emergency Plan, Menu, Daily Program, and Car Seat Law). LPA reviewed 10 random children's and 5 random staff's files. There are menus posted at least one week in advance and are visible to the child's authorized representative.

Facility has IMS Policy on file.
Facility's profile contains current telephone number.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

An exit interview was conducted with Lisa, director, including but not limited to Appeal Procedures, Site Visit, and Initial Appeal Rights.
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: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/14/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/14/2019
LIC809 (FAS) - (06/04)
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