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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 410518990
Report Date: 08/17/2022
Date Signed: 08/17/2022 10:30:28 AM


Document Has Been Signed on 08/17/2022 10:30 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:SAN MATEO-FOSTER CITY SCHL DIST - GEORGE HALLFACILITY NUMBER:
410518990
ADMINISTRATOR:HASELTON, KARRIEFACILITY TYPE:
850
ADDRESS:130 SAN MIGUELTELEPHONE:
(650) 312-7533
CITY:SAN MATEOSTATE: CAZIP CODE:
94403
CAPACITY:48CENSUS: 15DATE:
08/17/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:15 AM
MET WITH:Karrie HaseltonTIME COMPLETED:
10:45 AM
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On August 17, 2022 at approximately 8:15am, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. Upon LPA's arrival, LPA met with preschool classroom #2's head teacher, Sophia Porras Castillo, and explained the purpose of the inspection. Head teacher notified principal via phone of LPA's visit.

Preschool program operates on George Hall Elementary School in classrooms #2 and #24. Present in classroom #2 is 7 enrolled children with 3 staff members. Present in classroom #24 is 8 children with 3 staff members. Total children present during LPA's visit included 15 children with 6 staff members. Preschool program is operating within its capacity requirements and ratios during LPA's visit.

At approximately 8:45am, principal, Karrie Haselton, arrived to facility. LPA continued inspection with principal. All staff members working in preschool program are fingerprint cleared through SMFCSD. Preschool program operates Monday through Friday 8:15am to 12:00pm. Additional care is available if needed through 3:00pm.

LPA inspected the preschool classrooms and outdoor area for health and safety hazards. Classrooms have a working telephone on site. Entire facility has installation of smoke and fire alarm system implemented by school district. LPA observed classroom to have working carbon monoxide detectors and fully charged fire extinguishers. All cleaning solutions, poisons and other chemicals are stored inaccessible to children on facility's high shelves or high cabinets. Classroom has age appropriate furniture and materials that are in good working condition. Storage for children's belongings are located outside the classroom.

Classroom #2 has two toilets and one sink. Classroom #24 has one toilet and two sinks. Bathrooms were observed to be in good working condition with appropriate sanitation products. Accessible sinks located in the classroom are free of poisons or hazardous materials. Accessible sinks do not produce water that is warmer than 120 degrees Fahrenheit.

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SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 08/17/2022
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: SAN MATEO-FOSTER CITY SCHL DIST - GEORGE HALL
FACILITY NUMBER: 410518990
VISIT DATE: 08/17/2022
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Preschool program is not currently providing a food program. Enrolled children currently bring their own meals and food to the facility in their individually stored items. Facility also has sufficient amount of sleeping cots available for children in napping program. Drinking water is available to children, indoors and outdoors, with children's individual drinking bottles and accessible water fountains.

Preschool program has exclusive use of outdoor area that is separate from entire facility's outdoor area. LPA observed outdoor area to have age appropriate materials that are in good working condition. Resilient padding is located under climbing structure.

LPA observed preschool program to use paper sign in/out system. At time of inspection, all children were properly signed in to program with parents' full signatures. Classroom has license and all other required documents posted and visible for the public. Preschool program conducts monthly disaster drills with George Hall Elementary School. On date of LPA's visit, elementary school had not yet conducted disaster drill as school resumed 08/11/2022.

LPA reviewed 10 children's files and 6 staff members files. Children's and staff files were complete with a record of emergency identification information on file. Multiple staff members on site have a valid CPR/First Aid certificate that will expire 05/2023. Staff members also have proof of required immunizations that were made available for review.

Principal was informed that as of 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.

Principal 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.

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SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
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: 08/17/2022
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Principal is aware that all staff hired are required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completed certificate on file. LPA encourages principal to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

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/inspection-process.

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 Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

No deficiencies were issued under CCR, Title 22, Division 12.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with principal, Karrie Haselton.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina QuimboTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/17/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/17/2022
LIC809 (FAS) - (06/04)
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