410509670-10-25-2019-05-CC-FBRR-BHAV5Y-20191025160844

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410509670
Report Date: 10/25/2019
Date Signed: 10/25/2019 04:08:52 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:	HIGHLANDS RECREATION CENTER		FACILITY NUMBER:	410509670
ADMINISTRATOR:	KOENIG, MICHAEL		FACILITY TYPE:	840
ADDRESS:	1851 LEXINGTON AVENUE		TELEPHONE:	(650) 341-4251
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY:	86	CENSUS: 27	DATE:	10/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:30 PM
MET WITH:	Michael Koenig		TIME COMPLETED:	04:30 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	Licensing Program Analyst (LPA) Faye Bremer conducted an unannounced Annual inspection. LPA met with Director Michael Koenig and explained purpose of inspection. There were 27 school-aged children present with 7 teachers with 1 assistant in addition to Director Michael Koenig. LPA toured and inspected the physical plant for any health and safety hazards. The program has been moved temporarily to the Muti-Purpose Room (MPR) which is attached to the Preschool program (License # 414001561) due to the construction occurring adjacent to the Main building. Director Michael Koenig states that a new ADA accessible pathway is being constructed, and a new building is being constructed, with new boys and girls bathrooms. There are portable toilets and portable hand washing areas available on site strictly for children's use only. According to Director Michael Koenig, these portable restroom facilities are serviced every Tuesday. LPA inspected portable sinks, which had water, soap, and paper towels available. There is one additional unisex bathroom in the building, adjacent to the MPR. LPA advised Director Michael Koenig to submit to Licensing an updated facility sketch for both the current classroom in use, as well as the proposed construction with planned completion date, as well as a new updated LIC610. Licensee also advised Director to submit an updated Plan of Operation regarding how the facility shall meet the children's needs without disruption, during the construction. This facility has a pool, which was observed to be uncovered during today's inspection, but pool is made inaccessible to children via self-latching gates leading to the swimming pool. There are lifeguards on duty at this pool. There are no firearms or weapons on the premises. All cleaning compounds, detergents or other hazardous items are stored in the locked janitorial closet, inaccessible to children. There is drinking water available for children indoor and outdoor. The outdoor play area was inspected and appears to be clean, safe and all equipment appears to be in good condition. There is sufficient cushioning underneath the play structures. The MPR was observed to have sufficient age appropriate toys, furniture and equipment. There is a kitchen area with an oven in the MPR, and per Director, children are not allowed in the kitchen area. Teachers supervise the children in the room to ensure that the children do not enter the kitchen area. Continues on following LIC809C.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye Bremer	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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: HIGHLANDS RECREATION CENTER	FACILITY NUMBER: 410509670
	VISIT DATE: 10/25/2019

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LPA reviewed a sample of children and staff files. Children's files are complete with all necessary emergency forms and signed agreements. CPR and first aid for Director Michael Koenig expires May 2020.

In order to keep our files updated, the following forms shall be updated and submitted to CCL by Friday November 8, 2019:
-LIC309 Administrative Organization
-LIC500 Personnel Report
-Facility Floor Plan
-LIC610 Emergency Disaster Plan
-Plan of Operations
-Daily Activity Schedule

No deficiencies cited
Report reviewed and provided to Director Michael Koenig

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Faye Bremer	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

LIC809 (FAS) - (06/04)

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