410518192-3-6-2024-05-CC-MOLN-D34UXD-20240306145811

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410518192
Report Date: 03/06/2024
Date Signed: 03/06/2024 02:58:31 PM

Document Has Been Signed on 03/06/2024 02:58 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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	WOODSIDE ELEMENTARY PRESCHOOL		FACILITY NUMBER:	410518192
ADMINISTRATOR:	DAYEH, LISA		FACILITY TYPE:	850
ADDRESS:	3195 WOODSIDE RD.		TELEPHONE:	(650) 851-1571
CITY:	WOODSIDE	STATE: CA	ZIP CODE:	94062
CAPACITY:	48	CENSUS: 31	DATE:	03/06/2024
TYPE OF VISIT:	Required - 3 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Lisa Dayeh		TIME COMPLETED:	03:15 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	On March 6, 2024, at approx. 10:30AM Licensing Program Analyst (LPA) Maria Olguin-Leon met with Director Lisa Dayeh for an unannounced annual inspection visit. Purpose of inspection was explained. Present today, Director, 5 staffr and 31 children. Facility is operating within capacity and in compliance with staff/child ratio. All staff have fingerprint clearances. Facility operates preschool program from Monday to Friday 8:30 AM to 3:15 PM. LPA and Director toured the facility for health and safety hazards. Facility operates a preschool program on the campus of Woodside Elementary School in room 1A & 1B. Facility is clean with proper temperature and ventilation. There are plenty of age-appropriate toys, furniture, learning materials and sleeping cots all in good repair. Storage Cubbies are available for children to store personal items and belongings. There are two bathrooms and two sinks in each classroom. Toilets are in working condition and there is no hot running water in sinks. There is a separate staff bathroom in classroom 1A. There is a Kitchen/Prep room located between both classroom and inaccessible to children with closed doors. All cleaning products, chemicals and toxins are stored and locked in cabinet and inaccessible to children. Facility has plenty of sleeping cots available for napping; facility provides sheet and blankets to children and are laundered weekly. Playground is equipped with a large age-appropriate play structure, two swing set, ride on toys and a sandbox area all in good condition. Playground is surrounded with a 5 ft. fence. Play structure flooring is cushioned with tanbark to cushion falls. Playground is also surrounded with cement walkways for children to play. There are no pools or bodies of water. Per Director, there are no weapons or firearms on the premises. Children bring their own lunches form home and facility provides snacks to children in care. Menus are available and posted in classrooms. Kitchen storage area was observed to be clean, and food stored properly to prevent contamination. Labeled water bottles with children’s names are used indoors and outdoors. Facility refills water with Brita filtered water. First aid kit is fully stocked with medical supplies. Incidental Medical Services were discussed. Sick children are isolated in office away from other children. Page 2...

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

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 CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WOODSIDE ELEMENTARY PRESCHOOL	FACILITY NUMBER: 410518192
	VISIT DATE: 03/06/2024

NARRATIVE

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Facility uses Brightwheel electronic sign in/sign outs. Parents and authorized pick-up representative use a PIN # to sign into system. Facility is equipped with fully charged fire extinguishers, working carbon monoxide detectors and smoke alarm system. Last emergency drill was conducted on 02/28/2024 and properly documented. Facility is equipped with a landline phone and staff communicate via intercom system iPad and walkie talkies.

LPA reviewed 6 children’s records 5 staff record. All the children's and staff records were complete. 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. Trash cans have tight fitting lids.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records.

For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-care-centers/.

LPA discussed the safe sleep regulations with licensee [or facility representative] and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed licensee [or facility representative] of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

Cont. page 3...

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

LIC809 (FAS) - (06/04)

Page: 3 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WOODSIDE ELEMENTARY PRESCHOOL	FACILITY NUMBER: 410518192
	VISIT DATE: 03/06/2024

NARRATIVE

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Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a maximum of 30 days per person will be assessed if this regulation is violated.

Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test.

For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPA referred licensee [or facility representative] to the Department website for lead: Lead Toxicity Prevention and Water Testing Information.

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

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Cont. page 4...

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

LIC809 (FAS) - (06/04)

Page: 4 of 5

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WOODSIDE ELEMENTARY PRESCHOOL	FACILITY NUMBER: 410518192
	VISIT DATE: 03/06/2024

NARRATIVE

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To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process

See page 809D for deficiencies cited today, under Title 22 Division 12 of the California Code of Regulations.
A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the Director, Lisa Dayeh.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

LIC809 (FAS) - (06/04)

Page: 5 of 5

Document Has Been Signed on 03/06/2024 02:58 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: WOODSIDE ELEMENTARY PRESCHOOL	FACILITY NUMBER: 410518192
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/06/2024

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Type B

Section Cited

HSC

1597.16(a)(1)

Lead Testing

(1) A licensed child day care center, as defined in Section 1596.76, that is located in a building that was constructed before January 1, 2010, shall have its drinking water tested for lead contamination levels on or after January 1, 2020, but no later than January 1, 2023, and every five years after the date of the initial test. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above by not completing lead testing by January 1, 2023 which poses a potential health, safety or personal rights risk to persons in care. Or submit proof building was built after 2010.
	POC Due Date: 04/08/2024
	Plan of Correction
1 2 3 4	Director will submit proof building was built after 2010 and new piping was installed.

Type B

Section Cited

CCR

101216(f)

Personnel Requirements

(f) At least one staff member who is trained in pediatric cardiopulmonary resuscitation and pediatric first aid pursuant to Health and Safety Code Section 1596.866 shall be present when children are at the child care center or offsite for center activities. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on interview and record review, the licensee did not comply with the section cited above in 5 out of 5 staff did not complete training, which poses/posed a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 03/20/2024
	Plan of Correction
1 2 3 4	Director will complete CPR/First Aid training and submit certification to LPA.

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Maria Olguin-Leon	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/06/2024

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/06/2024

LIC809 (FAS) - (06/04)

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