414000373-8-16-2022-05-CC-HLEG-CHCQWD-20220816123147

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000373
Report Date: 08/16/2022
Date Signed: 08/16/2022 12:31:55 PM

Document Has Been Signed on 08/16/2022 12:31 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	CLUB HAPPY HALL GREEN HILLS		FACILITY NUMBER:	414000373
ADMINISTRATOR:	ROLDAN, ROSA		FACILITY TYPE:	840
ADDRESS:	401 LUDEMAN LN. PORT.B & AUDIT		TELEPHONE:	(650) 872-2582
CITY:	MILLBRAE	STATE: CA	ZIP CODE:	94030
CAPACITY:	78	CENSUS: 0	DATE:	08/16/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:45 AM
MET WITH:	Tiffany Tamin		TIME COMPLETED:	12:31 PM

NARRATIVE

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On 8/16/2022, Licensing Program Analyst (LPA), Hanson Leong, made an unannounced annual visit to the Club Happy Hall Green Hills facility. LPA was granted entry by a teacher, Tiffany Tamin. LPA explained the purpose of the visit to the teacher. During the visit, Rachel Heck, the executive director, arrived at the facility.. All facility’s staff members have had their criminal background checks cleared by Guardian. LPA observed five teachers preparing the facility for the upcoming school year. There were no children present in the facility

Both LPA and the Director thoroughly checked the facility for potential health and safety hazards. Toys, furniture, and learning materials are all age appropriate in all classrooms. LPA observed that the outside furniture and play structures are in excellent condition. Wood chips surround the outdoor play structures, absorbing any accidental falls. LPA observed that there were no bodies of water at the facility. All cleaning products, poisons, and other hazardous chemicals have been kept out of reach of children. The facility has smoke detectors, carbon monoxide detectors, fully charged fire extinguishers, centralized smoke alarms, and working phones. According to the Director, there are no firearms or weapons in the facility.

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 in care at the time, the files pertaining to those children were not reviewed.

LPA reviewed the records of five staff members. All required forms were in the staff files. A review of staff records revealed that all staff members are currently certified in CPR and First Aid.

According to the Director, the Center simulates 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: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

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: CLUB HAPPY HALL GREEN HILLS	FACILITY NUMBER: 414000373
	VISIT DATE: 08/16/2022

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Continued, Page 2
LPA reviewed the new director's credentials and supporting documentation. Following a final review, Marina Hamack, the new director, is determined to meet the department's requirements for a director by the LPA.

Incidental Medical Services (IMS) policy was discussed. 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

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

A copy of this report, and the “Notice of Site Visit” were given to the Executive Director.

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 Executive Director, Rachel Heck

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Hanson Leong	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 08/16/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/16/2022

LIC809 (FAS) - (06/04)

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