414000082-5-16-2023-05-CC-LTMO-CRVRT7-20230516131753

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000082
Report Date: 05/16/2023
Date Signed: 05/16/2023 01:18:06 PM

Document Has Been Signed on 05/16/2023 01:18 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:	CHAMPIONS-LAS LOMITAS ELEMENTARY (SA)		FACILITY NUMBER:	414000082
ADMINISTRATOR:	PFEIFFER, SHARON		FACILITY TYPE:	840
ADDRESS:	299 ALAMEDA DE LAS PULGAS		TELEPHONE:	(650) 250-3658
CITY:	ATHERTON	STATE: CA	ZIP CODE:	94027
CAPACITY:	276	CENSUS: 0	DATE:	05/16/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Director, Sharon Pfeiffer		TIME COMPLETED:	01:45 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	On May 16th, 2023 at approximately 11AM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, annual, required inspection. LPA met with Director, Sharon Pfeiffer and explained the purpose of the inspection. Present in the facility are Director and Site Supervisor. Upon arrival, the after-school program has not yet started and staff and children are not present. All adults working in the facility are fingerprint cleared and associated through the admin. facility of Champions-Sandpiper. Program operates on Las Lomitas Elementary School. Facility is licensed to operate in all the school classrooms. At this moment facility is operating in Room #222, 128, 201, 130, 37, and 39. Facility operates Mon-Fri from 1:30pm-6pm. LPA was unable to see each individual class as classrooms were in use by the elementary school. LPA was able to inspect Rooms #37 and #39. LPA observed each classroom to be clean and equipped with age appropriate toys and materials. Storage for children's belongings are located inside the classrooms. LPA observed facility has an installation of a fire alarm system inside each classroom as well as fully charged, fire extinguishers. The classrooms have a smoke and carbon monoxide detector installed as well as emergency kits with first aid materials and emergency contact information. Medication is stored appropriately, inaccessible to enrolled children and maintained with proper documentation. All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility provides snacks. Snack Menu is posted. Water is available to children indoors and outdoors. Facility has been tested their water for lead. Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that are in good working condition. Children are signed in by teacher and signed out by parents legal signature. Facility has license documentation and information properly posted and available for review in the entrance of the classroom. LPA reviewed facility records that included 5 children's records and 5 staff records. LPA observed children's and staff's records to be complete. At least one staff has an up to date CPR & First Aid certificate. All staff have up to date Mandated Reporter Certificate. Last emergency drill was conducted 04/2023. Emergency drills are conducted at least once every six months and are properly logged and documented. Continued on Page 2...

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

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: CHAMPIONS-LAS LOMITAS ELEMENTARY (SA)	FACILITY NUMBER: 414000082
	VISIT DATE: 05/16/2023

NARRATIVE

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Facility 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.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Directors were 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.

This facility is providing Incidental Medical Services – IMS at this time. Facility will be developing a written plan and submit to the department.. 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

Based on today's inspection, deficiencies were not observed, according to California Title 22, Health and Safety Code of Regulations.

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

Exit interview conducted and report was reviewed with Director, Sharon Pfeiffer.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/16/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/16/2023

LIC809 (FAS) - (06/04)

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