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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410506949
Report Date: 04/11/2023
Date Signed: 04/11/2023 01:21:04 PM


Document Has Been Signed on 04/11/2023 01:21 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)FACILITY NUMBER:
410506949
ADMINISTRATOR:CORTEZ, ELVIRAFACILITY TYPE:
850
ADDRESS:2434 MCGARVEY WAYTELEPHONE:
(650) 482-2038
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94061
CAPACITY:72CENSUS: 23DATE:
04/11/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Ivonne CastilloTIME COMPLETED:
01:35 PM
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On April 11, 2023 @ 10:00 AM, LPA Olguin-Leon conducted an unannounced annual inspection at the RCSD Child. Dev. Services-Roosevelt site. LPA met with Site Supervisor, Ivonne Castillo and purpose of visit was explained. Facility operates a preschool program at the Roosevelt Elementary School in classroom 34,35, and 36. Rooms 34 & 36 operates a year-round program and room 35 is a part time program, which follows the school calendar. Present for today’s visit was Site Director, 7 staff and 23 preschool children. Teacher and children capacity ratio requirements were observed to be in compliance. Hours of operation are Monday-Friday 7:00 AM-5:45 PM

LPA and Site Supervisor toured the facility for health and safety hazards. Facility consists of 3 classrooms in rooms 34, 35 and 35. All facility classrooms are clean with proper ventilation. There are plenty of age-appropriate toys, furniture and learning materials all in good repair. Cubbies are available for children to store personal items and belongings. There are restrooms in all the classrooms with toilets and sinks for washing hands. Bathroom sinks have no running hot water. There is separate bathroom for staff usage on the school ground premises. Classroom 34 has sufficient sleeping mats for all children and parents provide sheets. Classroom 36 has new sleeping cots and facility provides sheets. Sheets are sent home with parents for washing. Facility has two outdoor play areas; one is located on the school grounds. Playground behind classroom has asphalt flooring and plenty of play toys. School playground has swing set and play structure. Playground flooring has tanbark for cushioning falls. There are no pools, spas, or other similar bodies of water on the premises. Per Site Supervisor, there are no firearms or weapons on site.

The facility provides breakfast, lunch, and snacks for children via an outside vendor. Menus are posted in classroom and changed monthly. Classrooms have kitchenettes with sink and refrigerator for properly storing food. Children have their own labeled water bottles to use inside or outside. Facility offers filtered water to refill water bottles. All cleaning supplies and toxins are properly stored and inaccessible to children.
Cont. Page 2...

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 04/08/2023
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 4


STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)
FACILITY NUMBER: 410506949
VISIT DATE: 04/11/2023
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LPA reviewed 6 children’s records and 5 staff records. All children's records were complete. 5 staff files were reviewed, 2 out 5 staff were missing Immunization records, technical assistance was cited. Facility has posted the required forms (i.e., License, menus, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law (updated), and Emergency Disaster Plan). Isolation for sick children is on small sofa in the reading area.

Incidental Medical Services were discussed with Site Supervisor and LPA observed medication to be properly stored, labeled, and inaccessible to children. There are first aid kits available in the classroom with plenty of medical supplies. Isolation area for sick children is in the office. All storage containers for solid waste have a proper lid. All cleaning products, chemicals, and toxins are inaccessible to children. Last emergency drill was conducted on March 6. 2023. Classrooms drills coincide with school schedule Each classroom has a complete record of sign-in/out sheets by authorized pickup person. Classrooms have a fully charged fire extinguisher, a smoke and carbon monoxide detector, and cell phones and working telephone available on site.

Site Supervisor was reminded that all adults 18 and over living or working in the facility including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their exsting clearance or exemption, prior to initial presence in a licensed Family Child Care Home. 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.

Site Supervisor was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Site Supervisor to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Cont. page 3

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC809 (FAS) - (06/04)
Page: 2 of 4
STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)
CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: RCSD CHILD DEV SERVICES-ROOSEVELT (PEC)
FACILITY NUMBER: 410506949
VISIT DATE: 04/11/2023
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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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

No deficiencies were issued today.

Exit interview conducted and report was reviewed with the Site Supervisor, Ivonne Castillo.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 04/11/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/11/2023
LIC809 (FAS) - (06/04)
Page: 3 of 4