<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410509197
Report Date: 07/14/2020
Date Signed: 07/14/2020 11:31:37 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:PENINSULA TEMPLE SHOLOM PRESCHOOLFACILITY NUMBER:
410509197
ADMINISTRATOR:STECKLEY, ALLISONFACILITY TYPE:
850
ADDRESS:1655 SEBASTIAN DRIVETELEPHONE:
(650) 697-2279
CITY:BURLINGAMESTATE: CAZIP CODE:
94010
CAPACITY:160CENSUS: 35DATE:
07/14/2020
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Allison SteckleyTIME 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
Due to the COVID-19 health crisis, and state, local county orders, a tele-inspection was conducted. Licensing Program Analyst (LPA) Van met with the Director, Allison Steckley, via Facetime at 10:00 am. Currently, there are 35 children in care. The purpose of the tele-inspection today is case management to incorporate room #11, and the multi-purpose room that has been converted into a classroom to accommodate and maintain 6-feet separation among the children during the COVID-19 crisis.

LPA observed that both classrooms are clean and orderly. The classrooms are set up for child care, and all furniture is in good repair. There are varieties of age-appropriate wooden blocks, toys, and books for the children. There are several child-size tables, chairs, and all tables have rounded corners. Also, Children tables are spacing at least 6-feet apart. All solid waste bins are appropriately covered. All cleaning products, detergents, and supplies are made inaccessible to children. Each classroom has a fully stocked first aid kit and emergency disaster supplies stored in an off-limit area.

Fire clearance approval was receipted from the Fire Inspector via email on July 9, 2020.

As of July 14, 2020, classroom #11 and the converted multi-purpose classroom are incorporated into the daycare. This report will be sent to the director via email with a read receipt confirmation in lieu of the director’s signature.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 07/14/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/14/2020
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 1