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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410518192
Report Date: 03/08/2023
Date Signed: 03/08/2023 12:52:54 PM


Document Has Been Signed on 03/08/2023 12:52 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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066



FACILITY NAME:WOODSIDE ELEMENTARY PRESCHOOLFACILITY NUMBER:
410518192
ADMINISTRATOR:THOMPSON, BRUCEFACILITY TYPE:
850
ADDRESS:3195 WOODSIDE RD.TELEPHONE:
(650) 851-1571
CITY:WOODSIDESTATE: CAZIP CODE:
94062
CAPACITY:48CENSUS: 34DATE:
03/08/2023
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:42 AM
MET WITH:Lisa DavehTIME COMPLETED:
01:10 PM
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On March 8, 2023 at 8:43AM. Licensing Program Analyst (LPA) Maria Olguin-Leon met with Director, Lisa Dayeh for required annual inspection. Purpose of inspection was explained. Present today, Director, 5 staff and 34 preschool children. Facility is operating within the capacity and in compliance with staff child ratio. Staff fingerprinting clearance is conducted via school district. Facility operates preschool program from Monday to Friday 8:30AM to 3:15PM.

LPA and Director toured the facility for health and safety hazards. Current facility operates on the campus of Woodside Elementary School in room 1A & 1B. Kitchen area is off limits and used for prepping learning materials and storing snacks. Facility is clean with proper ventilation. There are plenty of age-appropriate toys, furniture and learning materials all in good repair. Cubbies are available for children to store personal items and belongings. Both classrooms have one restroom each for children’s use and no running hot water. There is one staff restroom located in classroom A1. All trash containers in bathroom and in classroom have fitted lids. Facility has sufficient sleeping cots and provide sheets that are laundered weekly. Facility uses school playground which has play structure and other play toys available for children to play. Playground flooring has tanbark and asphalt and play area is completely fenced off with closed gates. There are two locked storage sheds for storing toys. There are no bodies of water.

Children bring their own lunches; facility provides two snacks. Children have their own labeled water bottles to use inside or outside and refilled during day with Brita filtered water. Both classrooms have fully stocked first aid kit and a large emergency bag is on facility premises. Incidental Medical Services were discussed, LPA observed children’s medication to be properly stored and documented with proper paperwork. Children’s IMS medication is stored in off limits kitchen. Isolation area for sick children is by office or elementary nursing station, All cleaning products, chemicals, and toxins are inaccessible to children. Facility uses online sign in/out system via Bright wheel. Classroom is fitted with working fire alarm system, two fully charged fire extinguishers, smoke detector and carbon monoxide detector, and a working telephone available on site. Fire Department conducts yearly inspections and monitor fire extinguishers. Facility is connected to Elementary alarm system.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/08/2023
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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: WOODSIDE ELEMENTARY PRESCHOOL
FACILITY NUMBER: 410518192
VISIT DATE: 03/08/2023
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LPA reviewed 5 children’s records and 5 staff record. All the children's records were complete and recorded online on Infosnap and used in conjunction with Brightwheel. The facility has all necessary paperwork posted, Facility License, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan. Last emergency drill was conducted on February 9th, 2023 and are done monthly. LPA collected change of Director paperwork for Lisa Dayeh.

Director was reminded that all adults 18 and over living or working in the home, 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 licensed Family Child Care Home. 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.

The Director was reminded about the Provider Information Notices (PINs) on the CCLD website. Licensee was informed that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. LPA reviewed AB 1207 with the Licensee. As of January 1, 2018, all staff must complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA encouraged the Director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

No deficiencies were issued today.

Exit interview conducted and report was reviewed with the Director, Lisa Dayeh.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8817
LICENSING EVALUATOR NAME: Maria Olguin-LeonTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/08/2023
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/08/2023
LIC809 (FAS) - (06/04)
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