<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410518969
Report Date: 09/23/2019
Date Signed: 09/23/2019 04:30:11 PM

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:FOOTSTEPS@CIPRIANIFACILITY NUMBER:
410518969
ADMINISTRATOR:MYERS, MITCHFACILITY TYPE:
840
ADDRESS:2525 BUENA VISTA AVENUETELEPHONE:
(650) 610-0715
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY:160CENSUS: 152DATE:
09/23/2019
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
02:00 PM
MET WITH:Mitch MyersTIME COMPLETED:
04:30 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) Glenn Schnell conducted a case management inspection today in response to a request by Licensee Karen Foletta Hass to increase the capacity of the facility from 160 to 180 children. As part of today's inspection, LPA Schnell inspected the current rooms to be used. This program is located on a functioning elementary school site (Cipriani Elementary School), and the portables and classrooms used are owned by the Belmont School District and leased to the licensee. Rooms to be used will be: Portable rooms 1 and 2, rooms 18, 19, 20 next to multipurpose room, multipurpose room including stage, rooms 7,8, 9, 10, 12, 13, 14, 15,16. Rooms 7,8, 9, 10, 12, 13, 14, 15,16 18, 19, 20 are used during school hours as classrooms by the elementary school. Licensee and Director Mitch Myers understand that staff must ensure rooms are safe and free of hazards before being occupied by children from this licensed program.

LPA observed that the Licensee has a letter from the school superintendent acknowledging that all rooms being requested for use have adequate space for 180 children and has a current fire clearance for Cipriani Elementary School dated June 21, 2019. LPA Schnell also received an updated LIC 500 Personnel Report.

LPA Schnell will recommend a capacity increase to 180 effective 9/23/19. Updated license to follow.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/23/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/23/2019
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 1