410517377-6-3-2019-05-CC-GSIH-BCSVBP-20190603161753

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410517377
Report Date: 06/03/2019
Date Signed: 06/03/2019 04:18:02 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:	CHILD DEV CTR-HENRY FORD CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	410517377
ADMINISTRATOR:	REYNOLDS, DEANNE P.		FACILITY TYPE:	840
ADDRESS:	2498 MASSACHUSETTS AVENUE		TELEPHONE:	(650) 368-1138
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	70	CENSUS: 48	DATE:	06/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:20 PM
MET WITH:	Belen Salazar		TIME COMPLETED:	03:30 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) Singh met with teacher, Belen Salazar, for a random annual inspection. Purpose of the inspection was explained. This is a combination center and is being operated from the portables at school property. Present, there are 48 children with four teachers. 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 2:20 PM to 6 PM, except on Thursday. On Thursday, facility operates from 1:20 PM to 6 PM. With teacher, LPA inspected the day care areas: Room A, Room B and Play yard. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone at the site. Each classroom has first aid supplies available. Facility has age appropriate furniture. Furniture is steady and in good repair. All shelves and other heavy furniture has been secured to the wall. 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. Per teacher, the facility provides the meal to the children. Per teacher, meals are being prepared by the staff before the children arrive. All the food is stored in properly manner and has lid to avoid any contamination. 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. At 2:30 PM, LPA reviewed the facility records. All of required documents needs to be posted are posted and are visible for public. Facility has food menus posted in one week advance. LPA reviewed random children's and all present staff's files. Per teacher, all staff is scheduled to renew the CPR training on June 9, 2019. LPA reviewed the educational qualification of all the teachers. 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: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

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: CHILD DEV CTR-HENRY FORD CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 410517377
	VISIT DATE: 06/03/2019

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

The facility is aware all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates in staff files. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the teacher. 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: 06/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/03/2019

LIC809 (FAS) - (06/04)

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