410509659-2-28-2022-05-CC-HLEG-CC44JQ-20220228180908

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410509659
Report Date: 02/28/2022
Date Signed: 02/28/2022 06:10:32 PM

Document Has Been Signed on 02/28/2022 06:10 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	NORTH HILLSBOROUGH PRESCHOOL		FACILITY NUMBER:	410509659
ADMINISTRATOR:	TRUE, MARCIA		FACILITY TYPE:	850
ADDRESS:	545 EUCALYPTUS AVENUE		TELEPHONE:	(650) 342-1478
CITY:	HILLSBOROUGH	STATE: CA	ZIP CODE:	94010
CAPACITY:	17	CENSUS: 18	DATE:	02/28/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	02:00 PM
MET WITH:	Marcia True		TIME COMPLETED:	06:15 PM

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	On February 18, 2022, Licensing Program Analysts (LPAs), Leong and Van, conducted an unannounced annual random inspection with Director Marcia True. The LPA explained the inspection’s purpose to the director. All staff at the facility have fingerprint clearance. The Director and one teacher are supervising eighteen children at the Center, which is over the license capacity. The staff to children ratio was not met. The director applied to increase capacity in June 2021. The director did not follow up with the application’s required missing documents. The Hours of operation are Monday to Friday, 8:30 a.m. to 3:15 p.m. LPAs and the Director inspected the facility for potential health and safety hazards. In all classrooms, toys, furniture, and learning materials are age appropriate. The furniture appears to be in good shape. LPAs noticed that each child has a cubby labeled with their name. All cleaning products, poisons, and other hazardous chemicals have been kept out of children's reach. The outdoor play structures are age-appropriate and well-kept. The facility has sand beneath all play structures to absorb accidental falls. The facility has no bodies of water on the premises, as well as multiple carbon monoxide detectors, a centralized smoke alarm, multiple fully charged fire extinguishers, and working telephones. LPAs observed that the facility had posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities.) Children have access to drinking water via water fountains. All solid waste storage containers within the Center have a proper tight-fitting cover. (*See Page 2 for continuation*)

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

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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Document Has Been Signed on 02/28/2022 06:10 PM - It Cannot Be Edited

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: NORTH HILLSBOROUGH PRESCHOOL	FACILITY NUMBER: 410509659
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 02/28/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1596.8662(b)(1)

Administration of Child Day Care Licensing

(1) On or before March 30, 2018, a person who, on January 1, 2018, is a licensed child day care provider, administrator, or employee of a licensed child day care facility shall complete the mandated reporter training provided pursuant to paragraphs (2) and (3) of subdivision (a), and shall complete renewal mandated reporter training every two years following the date on which he or she completed the initial mandated reporter training. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation and record review, both the director and teacher did not complete the mandated reporter certificate, which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/07/2022
	Plan of Correction
1 2 3 4	Director stated both herself and the teacher will complete the mandated reporter training by 3/7/22.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

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: NORTH HILLSBOROUGH PRESCHOOL	FACILITY NUMBER: 410509659
	VISIT DATE: 02/28/2022

NARRATIVE

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During the inspection, ten random children's records and two personnel records were reviewed. The facility has a sign-in/out log with parents' signatures. A review of the facility's records revealed that the names, addresses, and phone numbers of each child's authorized representative are kept on file. In addition, each child's immunization record can be found in their file. A review of staff records revealed that both the director and teacher CPR certifications expired and will sign up for a class. LPAs reviewed both director and teacher have the required ECE units. According to the Director, the Center simulates fires and earthquakes on a monthly basis.

The Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to initial presence in a Child Care Center. 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.

Incidental Medical Services (IMS) policy was discussed. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

(***See page 3 for continuation***)

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

LIC809 (FAS) - (06/04)

Page: 3 of 4

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: NORTH HILLSBOROUGH PRESCHOOL	FACILITY NUMBER: 410509659
	VISIT DATE: 02/28/2022

NARRATIVE

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The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

LPAs encouraged the Director to frequently visit the Licensing 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.

See 809-D for deficiency, cited today on 2//28/22

Exit interview conducted, and report reviewed with the area director, Tony Giacomazzi

The unannounced annual inspection report, site visit notice and deficiency will be emailed to the Director by the end of business hour today. Appeal Rights was discussed with director. Confirmation of receipt is required. The LPA advised the Director that the site visit notice would have to be posted for 30 days.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/28/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/28/2022

LIC809 (FAS) - (06/04)

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