410518990-9-19-2019-05-CC-MROZ-BG6VQ6-20190919163749

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 410518990
Report Date: 09/19/2019
Date Signed: 09/19/2019 04:38:03 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:	SAN MATEO-FOSTER CITY SCHL DIST - GEORGE HALL		FACILITY NUMBER:	410518990
ADMINISTRATOR:	HASELTON, KARRIE		FACILITY TYPE:	850
ADDRESS:	130 SAN MIGUEL		TELEPHONE:	(650) 312-7533
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	48	CENSUS: 16	DATE:	09/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:45 AM
MET WITH:	Cristina Blanco		TIME COMPLETED:	01:05 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) Marie Rodriguez made an unannounced Annual Random inspection. LPA met with Staff in Charge/Teacher Cristina Blanco and explained purpose of inspection. Director Karrie Haselton was contacted by phone and LPA explained purpose of inspection. Director was unable to be at center during inspection due to all day training at another facility. The care center is located in classroom #2 and #24 inside George Hall Elementary School. Rooms operates Monday to Friday from 8:00am to 12:00pm. Present in Room 2 were two (2) teachers and 16 preschool children. Room 2 is operating within capacity requirements and in compliance with child to staff ratio. LPA inspected Room 2 with Staff in Charge. There are no bodies of water, firearms, or weapons on the premises. The room is in good condition with proper temperature and ventilation and is free of any hazards. All furniture is in good repair. Room has age appropriate toys and equipment. There are two bathrooms with one toilet each and two sinks located in classroom for children's use. Bathrooms appear to be clean, in good repair, and free of any hazards. There is a separate bathroom on the elementary school site for staff usage. A first aid kit and a first aid backpack are available. The outdoor play area is fenced for supervision. The play structure is age appropriate and in good condition with sufficient cushioning underneath. All required postings are posted on the bulletin board by the entrance to the center. Snacks are provided by assigned parent(s) or guardian(s) each day. A monthly calendar is posted showing which child is to provide the snack and the menu for the snack is posted each day. Drinking water is available at the water fountain by the sinks. Food preparation area is clean and free of any toxins or contamination. All food is properly stored to avoid contamination. All storage containers for solid waste have a proper lid. All cleaning products, chemicals, and toxins are inaccessible to children. (Continued on second page)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) -26-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

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: SAN MATEO-FOSTER CITY SCHL DIST - GEORGE HALL	FACILITY NUMBER: 410518990
	VISIT DATE: 09/19/2019

NARRATIVE

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(Continued from first page)

Incidental Medical Services was discussed with Staff in Charge. There are no children receiving services during this school year. Last emergency drill was conducted on September 17, 2019. Emergency drills are conducted every month and properly logged. The center has a complete record of sign-in/out sheets by authorized pickup person. There is a working fire alarm system and smoke and carbon monoxide detectors, a fully charged fire extinguisher, and a working telephone available.

Five children records reviewed were complete. All children have a record of emergency identification information on file. Two staff records reviewed were complete. All staff have a criminal record clearance on file with the School District. Staff have current Pediatric First Aid/CPR certificates on file. Mandated Reporter training was taken at the beginning of this month.

During inspection,
· Staff in Charge was reminded all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.662.
· Staff in Charge was reminded about Mandated Reporter Training available on CCLD website. Training must be completed every two years. (Websites: www.ccld.ca.gov or www.mandatedreporterca.com)
· Staff in Charge was reminded about the Provider Information Notices (PINs) on CCLD website.

No deficiencies cited today.

An Annual Continuation Inspection will be conducted at a later date for Room 24.

This report was reviewed and discussed with Staff in Charge Cristina Blanco. A copy of report was provided. Notice of site visit was observed being posted and shall remain posted for 30 days.

Any additional questions, call CCLD Office, Monday - Friday, 8am - 5pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) -26-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/19/2019

LIC809 (FAS) - (06/04)

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