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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410517962
Report Date: 02/24/2020
Date Signed: 02/24/2020 11:22:24 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:WARD, STEPHANIEFACILITY NUMBER:
410517962
ADMINISTRATOR:WARD, STEPHANIEFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(650) 329-8517
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:14CENSUS: 11DATE:
02/24/2020
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Licensee, Stephanie WardTIME COMPLETED:
11:40 AM
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Licensing Program Analyst (LPA), Cindy Interiano, met with Licensee, Stephanie Ward. Purpose of the inspection was explained and was for an Annual/Random inspection. Present is Licensee and Helper caring for 11 children (1 infant and 10 PreK). Licensee is within capacity limits of a Large capacity License. Licensee owns home, which is a 3 bedroom, 2 bathroom, single story house. Licensee lives with Adult Daughter. All adults have criminal record clearance. Facility was inspected and Daycare areas are: Living Room, Bedroom #3, Bathroom #2 (in the Den), and Backyard. Off Limit areas are: Kitchen (pass through only to Bathroom #2), Den, Bathroom #1, Bedroom #1 and #2. Off limit areas, including closets, are properly barricaded. LPA observed the following: Daycare area is clean, orderly, and equipped with age appropriate toys and equipment for the children. Home has sufficient lighting and ventilation. Home has a working telephone, a working smoke and carbon monoxide detector and a fully charged fire extinguisher. Chimney in the Living Room is properly barricaded. Home has no bodies of water. There are no poisons, detergents, or cleaning products accessible to daycare children. Licensee states there are no guns/weapons in the home. Licensee’s CPR expires in 03/2020. Licensee’s daughter also has current CPR training on file. Licensee conducted last emergency drill on 09/30/20 and is properly logged. Licensee provides daily snacks and meals. Discipline policy is mainly redirection and at times ‘time out’ that does not exceed one minute per age of the child. All required postings are properly posted. Licensee and Daughter have required proof of immunization on file. Licensee has Mandated Reporter training certificate on file. Children’s roster was reviewed and is complete and up-to-date.

See Page 2. . .
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
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 2
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: WARD, STEPHANIE
FACILITY NUMBER: 410517962
VISIT DATE: 02/24/2020
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Page 2. . .

During inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Licensee was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Licensee was reminded about the Provider Information Notices (PINs) on CCLD website.
*Licensee was reminded about Mandated Reporter Training available on CCLD website
(www.ccld.ca.gov or www.mandatedreporterca.com).
*Licensee was advised of the new Lead Bill (effective 01/01/19), requiring Facilities to distribute a two-page flyer to Guardians with information on lead poisoning facts.
*Licensee was given information regarding ‘Safe Sleep’ practices.

>No deficiencies were issued today under Title 22 Division 12 of the Ca. Code of Regulations.

>This report and rights to comment and appeal were discussed with Licensee. This report must be available in the facility for public review. Notice of site visit was observed being posted.
Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/24/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/24/2020
LIC809 (FAS) - (06/04)
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