410518963-10-11-2022-05-CC-HLEG-CK4Q7Q-20221011115532

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410518963
Report Date: 10/11/2022
Date Signed: 10/11/2022 11:56:38 AM

Document Has Been Signed on 10/11/2022 11:56 AM - It Cannot Be Edited

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:	CSSF REC DET-MONTE VERDE AFTER SCHOOL REC PROGRAM		FACILITY NUMBER:	410518963
ADMINISTRATOR:	DANELE DIXON		FACILITY TYPE:	840
ADDRESS:	2551 ST. CLOUD DRIVE		TELEPHONE:	(650) 742-0613
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	200	CENSUS: 0	DATE:	10/11/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:10 AM
MET WITH:	Kimberly Morrison		TIME COMPLETED:	12:10 PM

NARRATIVE

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On 10/11/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the CCSF Monte Verde facility. The LPA was granted entry by the Program Supervisor, Kimberly Morrison. The LPA explained the purpose of the visit to the program supervisor. Guardian, the department's system for conducting background checks, has confirmed that all the individuals listed on the facility’s roster have been granted permission to work or be present in a childcare facility. During the visit, there was no children present in the facility.

LPA and the program supervisor both performed comprehensive inspections of the facility to look for possible threats to health and safety. The facility offers a first aid kit that is completely loaded with everything that is required for the treatment of wounds and other types of injuries. Toys, furnishings, and learning materials in all classes are age appropriate. The LPA saw that the playground equipment and outdoor furnishings are in very good shape. The outdoor play structures are surrounded by rubberized cushions, which can cushion any falls that may occur. The LPA noted that there were no bodies of water present at the facility. All poisons, cleaning products, and other potentially harmful substances have been stored in a location that is inaccessible to children. The building is equipped with smoke detectors, carbon monoxide detectors, fire extinguishers that are properly charged, centralized smoke alarms, and phones that are in working order. The program supervisor has stated that the facility does not house any firearms or other types of weapons.

The LPA observed that the facility posted the required documents. (i.e., license, waivers, notification of parental rights, notification of personal rights, car seat law, emergency disaster plan, and daily activities).

Because there were no children or staff present, their files were not reviewed.

According to the program supervisor, the facility simulates and documents fire and earthquake drills monthly. *** See Page 2 for continuation***

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

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: CSSF REC DET-MONTE VERDE AFTER SCHOOL REC PROGRAM	FACILITY NUMBER: 410518963
	VISIT DATE: 10/11/2022

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Continued, Page 2
The program supervisor was reminded that all adults 18 and over, 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 Child Care Center. 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.

Incidental Medical Services (IMS) policy was discussed with the program supervisor. For IMS information, see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

The LPA encouraged the program supervisor to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. The program supervisor can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies were issued today

A copy of this report, the “Notice of Site Visit,”and their appeal rights were given to the program supervisor.

A Notice of Site Visit must remain posted for 30 days.

Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

An exit interview was conducted, and the report was reviewed with the Program Supervisor, KImberly Morrison

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/11/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/11/2022

LIC809 (FAS) - (06/04)

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