414000476-6-6-2023-05-CC-LGOZ-CSJSZ2-20230606141824

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000476
Report Date: 06/06/2023
Date Signed: 06/06/2023 02:18:35 PM

Document Has Been Signed on 06/06/2023 02:18 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-SANDPIPER ELEMENTARY		FACILITY NUMBER:	414000476
ADMINISTRATOR:	MCLAUGHLIN, MICHELE		FACILITY TYPE:	840
ADDRESS:	797 REDWOOD SHORES PARKWAY		TELEPHONE:	(650) 780-7322
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94065
CAPACITY:	75	CENSUS: 2	DATE:	06/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:00 PM
MET WITH:	Michele Mclaughlin		TIME COMPLETED:	02:20 PM

NARRATIVE

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On 6/6/2023 at 12:15PM., Licensing Program Analyst, (LPA) Luis J. Gomez met with Director, Michele Mclaughlin. The purpose of the inspection was explained and is for an Unannounced; Annual Inspection. This is a school-age, after-school program located next to Sandpiper Elementary. Present was the director and three staff supervising two children. Children present have been properly signed in. Facility is within capacity limits of the license on this day. Program operates year-around, using one classroom and one outdoor play yards. Days and Hours of operation are: Mon, Tues, Thurs, Fri, 2:00PM- 6:00PM. Wed, 12:00PM-6:00PM. LPA inspected facility, indoor and outdoor, with director for health and safety hazards.

At 12:20PM. LPA observed the following: Classroom inspected was clean, orderly with age-appropriate materials available for the children. Classrooms are equipped with desks, tables and chairs for seated activities. Art supplies, games and booked inspected were in proper repair. Classroom had acceptable ventilation and lighting. Detergents, toxins, supplies and have been made inaccessible. Classroom is equipped with smoke detector (Built-in), functioning monoxide detector and fully charged fire extinguisher (2A:10BC). Boys/ Girls bathrooms are located separate. Bathroom inspected were clean with adequate supplies for hand washing. Staff bathrooms are located separate.

LPA inspected kitchen/ food storage area. Per director, lunches and snacks are delivered biweekly. Food items inspected were correctly stored. Area was clean and free of trash or rubbish. LPA reminded director to discard all expired food items.

LPA inspected the outdoor play area. Play area was completely enclosed, with outside playthings in good repair. Rubber padding had been installed under play structure for added safety. Structure was properly anchored. LPA reminded facility to ensure shaded rest area is readily available at all times.

For water services, fountains are accessible inside and outside. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

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-SANDPIPER ELEMENTARY	FACILITY NUMBER: 414000476
	VISIT DATE: 06/06/2023

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(Page 2)
At 1:00PM LPA review facility records including three children’s and personnel files. Facility files reviewed and included staff’s: Health Screening (LIC503), Required Transcripts, Declaration to Report Suspected Child Abuse (LIC9108); Mandated Reporter Training Certification (AB1207); and Proof of Required Immunization.

Facility files were reviewed included children’s: Admission Agreement; Health History (LIC702); Immunization Record; Notification of Parent’s Right (LIC995A); Personal Rights (LIC613A); and Consent for Medical Treatment (LIC627).

Children’s medication and IMS plan was reviewed during inspection.

Present staff members had their current CPR/ 1^st aid certification, which expires: 5/2024.
Emergency drills are conducted at the facility, with the last drill done on 5/18/2022, properly logged.

Required posting were reviewed included the Facility License; Notice of Parents Rights (PUB393); Emergency Disaster Plan (LIC610); Earthquake Preparedness Checklist; and Updated Menu.

Director 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 Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm (REFER TO 809C FOR CONT.)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

LIC809 (FAS) - (06/04)

Page: 2 of 3

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-SANDPIPER ELEMENTARY	FACILITY NUMBER: 414000476
	VISIT DATE: 06/06/2023

NARRATIVE

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(Page 3)
Based on today's inspection, no deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Chapter 1, Ca. Code of Regulations. Exit interview was discussed with Mechele Mclaughlin, and director’s signature of this form acknowledges receipt of these documents.

This report and rights to comment were discussed. This report must be available in the facility for public review. Notice was given and must remain posted for 30 days. Facility was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/06/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/06/2023

LIC809 (FAS) - (06/04)

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