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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410509659
Report Date: 03/17/2022
Date Signed: 03/17/2022 11:33:57 AM


Document Has Been Signed on 03/17/2022 11:33 AM - 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 PRESCHOOLFACILITY NUMBER:
410509659
ADMINISTRATOR:TRUE, MARCIAFACILITY TYPE:
850
ADDRESS:545 EUCALYPTUS AVENUETELEPHONE:
(650) 342-1478
CITY:HILLSBOROUGHSTATE: CAZIP CODE:
94010
CAPACITY:17CENSUS: 15DATE:
03/17/2022
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Marcia TrueTIME COMPLETED:
11:45 AM
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On March 17, 2022, Licensing Program Analysts (LPAs) Van and Leong made unannounced Case Management inspection to increase capacity to the current License and met with Site Director Marcia True. The Department received an application from the Facility requesting a capacity increase on March 1, 2022. The Facility is currently licensed for 17 preschool-age children and requesting an increase to the capacity of 28 preschool-age children. There is two staff supervising 15 children. Days and hours of operation are Monday-Friday, 8:30 AM to 3:15 PM. Burlingame's Central County Fire Department has granted fire clearance on March 15, 2022.

The Facility operates in a Functioning School site at North Hillsborough Elementary School in classroom #16. No changes were made to the previously licensed indoor and outdoor. Based on the capacity worksheet dated November 19, 1991, classroom #16 had a measurement of 840 square feet, allowing for a capacity of 24 children. However, the Facility was only applied for a capacity of 17. During today's inspection, LPAs re-measured classroom #16 for accuracy and determined if the current layout of classroom #16 can accommodate the new requested capacity increase. With the current layout, the new measurement of classroom #16 today is 876.38 square feet, allowing for the capacity of 25 children.
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SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/17/2022
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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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: 03/17/2022
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Per Director, the outdoor space is only the area fenced behind and on the side of the classroom. The outdoor measurement is 1162 square feet, allowing for 15 children. Based on the current requested capacity and current outdoor square footage, the Facility will need to request a scheduled rotation outdoor waiver to meet the current requested capacity. The maximum capacity facility could be licensed for will depend on approved scheduled outdoor rotations.The outdoor play structures are age-appropriate and well-kept. The areas around and under high climbing equipment are cushioned with sands. Outdoor activity space surfaces are free of hazards.

The indoor and outdoor play areas are inspected for health and safety hazards. There are fully charged fire extinguishers that meet minimum requirements, smoke detectors, and carbon monoxide (CO) detectors present in the classroom. Children's bathrooms are inspected; the Facility has two toilets and two sinks, allowing 30 children. All toilets and hand washing facilities are in safe and sanitary operating condition. A separate staff bathroom is available. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Disinfectants, cleaning solutions, poisons, and other dangerous items to children are inaccessible. A variety of age-appropriate toys and materials for children are available in the classroom.

Although fire clearance was approved for 28 children, the indoor space can only accommodate 25 children based on the new square footage.

Prior to approving a capacity increase of 25 Preschool children,
  • The outdoor play area waiver must be reviewed and approved by asupervisor.
  • A final review is required from the Department before licensure.

The report was reviewed and signed by the Director, Marcia True. Today's report, March 17, 2022, and notice of site visit will be sent to the Director at mtrue@hcshk8.org by the close of business on March 17, 2022. Confirmation of receipt is required.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/17/2022
LIC809 (FAS) - (06/04)
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