410518662-4-19-2023-05-CC-AMEN-CR2QJA-20230419121226

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410518662
Report Date: 04/19/2023
Date Signed: 04/19/2023 12:12:30 PM

Document Has Been Signed on 04/19/2023 12:12 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:	COASTSIDE CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	410518662
ADMINISTRATOR:	CORZINE, KAREN		FACILITY TYPE:	830
ADDRESS:	565 REDONDO BEACH ROAD		TELEPHONE:	(650) 726-7416
CITY:	HALF MOON BAY	STATE: CA	ZIP CODE:	94019
CAPACITY:	27	CENSUS: 21	DATE:	04/19/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:25 AM
MET WITH:	Karen Corzine		TIME COMPLETED:	12:20 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) Andrea Medlin met with facility representative for this required annual licensing visit. Purpose of visit explained. Days and hours of operation: Monday-Friday 8:00AM-5:00PM. Physical plant toured to inspect for health and safety hazards. There are 21 infants present. Facility meets teacher/infant ratio today. The facility has a fully charged fire extinguisher that meets the minimum requirements, smoke detector, and a carbon monoxide detector (CO). Facility is licensed as a combination center which includes: infant and preschool programs. Facility is adequately furnished with age appropriate toys, furniture, cribs, changing tables, and equipment. Separate staff bathrooms are available. Outdoor play area inspected for health and safety hazards; areas around and under climbing equipment is cushioned with tanbark. Parent's provide diapers and formula. Sinks are present in the classrooms and located near the changing tables. No pools, spas, hot tubs, fish ponds or similar bodies of water are present. Disinfectants, cleaning solutions, poisons, and toxics are inaccessible to children. Per site director, there are no firearms or weapons on site. Classrooms are set up for child care and furniture and equipment for children is present. Adequate first aid supplies are available. Facility has posted all the required licensing forms in a prominent accessible location. LPA reviewed staff and children's files. In children's files reviewed, all records are complete. In the staff files reviewed, all records are complete. Staff have verification of the required mandated child abuse reporter training as compliant with AB1207. Staff have current Pediatric First Aid and CPR and director has current Pediatric First Aid and CPR (exp 7/2023). Staff have verification of the required staff immunizations: measels (MMR) and pertussis (TDap). (Continued on next page 809-C)

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

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: COASTSIDE CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 410518662
	VISIT DATE: 04/19/2023

NARRATIVE

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Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm. Facility informed that effective September 1, 2016, a person may not be employed or volunteer at a child care 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.

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.

This report is reviewed with facility representative and a copy of this report must be made available for public review upon request.

Notice of Site Visit posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/19/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/19/2023

LIC809 (FAS) - (06/04)

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