410509152-7-18-2019-05-CC-GSIH-BE7V2R-20190718160331

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410509152
Report Date: 07/16/2019
Date Signed: 07/18/2019 04:03:37 PM

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:	WOODLAND SCHOOL		FACILITY NUMBER:	410509152
ADMINISTRATOR:	WILLIAMS, FELICITY		FACILITY TYPE:	850
ADDRESS:	360 LA CUESTA		TELEPHONE:	(650) 854-9065
CITY:	PORTOLA VALLEY	STATE: CA	ZIP CODE:	94028
CAPACITY:	45	CENSUS: 11	DATE:	07/16/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Felicity Williams & Scott Harding		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 Analysts (LPAs) Singh and Cowan met with director, Felicity Williams, and teacher, Scott Harding, for a random annual inspection. Purpose of the inspection was explained. Present, there are eleven children in care with three staff and the director. Facility is operating with in the capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday between 8 AM to 6 PM. With director, LPAs inspected the day care classrooms and play yard. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, smoke detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility floor is in good repair and free of any hazards. All toilets, hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste and in good repair and have proper tight-fitted lid on top. Facility has drinking water available for children. All the materials and surface accessible to the children is clean and toxic free. Per teacher Scott, children bring their own meals. There is drinking water in play yard for children. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. There is sufficient amount of wood chips under the play structures to prevent any fall injuries. Play yard has shaded area for children to use. At 10:30 AM, LPAss reviewed the facility records. LPA observed that facility has sign in / out record with full legal signatures. LPA reviewed eight random children's and all present staff's files. LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Each child's record contain medical assessment. Multiple staff members has record of valid CPR card in file. LPA reviewed the educational qualification of all the teachers. The facility has license, emergency disaster plan and allergy list posted and visible. See next page for continuation .................

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

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: WOODLAND SCHOOL	FACILITY NUMBER: 410509152
	VISIT DATE: 07/16/2019

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Continuation from previous page ...........

LPA review AB 1207 with the director. 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. Both of the present staff members has completed the training.

LPA discussed the effects of lead exposure and a handout was provided. It was informed 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 teacher, Harding. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/16/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/16/2019

LIC809 (FAS) - (06/04)

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