<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414000538
Report Date: 06/16/2022
Date Signed: 06/16/2022 05:06:22 PM


Document Has Been Signed on 06/16/2022 05:06 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:JOBTRAIN, INC CHILD DEV CTRFACILITY NUMBER:
414000538
ADMINISTRATOR:AYALA, ROSAFACILITY TYPE:
850
ADDRESS:1200 O'BRIEN DRIVETELEPHONE:
(650) 330-6416
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY:24CENSUS: 6DATE:
06/16/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:15 AM
MET WITH:Site Supervisor, Rosa AyalaTIME COMPLETED:
11:20 AM
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 June 16th, 2022 at 9:15AM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced, annual, required inspection. LPA met with Site Supervisor, Rosa Ayala and explained the purpose of the inspection. Present in the facility are Site Supervisor and one staff caring for a total of 6 preschool age children. All adults working in the facility are fingerprint cleared and associated. Facility is currently operating within teacher to child ratio on this date.

Program operates M-F, 7am-4pm, year-round with periodic breaks throughout the year. Facility operates in one large classroom in the ‘Job Train; building. 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, labeled with each child's individual names. LPA observed facility has an installation of a fire alarm system inside the classroom as well as a fully charged, fire extinguishers. The classroom has 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 offers breakfast, lunch, and snack through the program Chefables. Monthly menu is posted. Water is available to children indoors and outdoors. Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that are in good working condition. Play structures have resilient padding. Children are signed in and out of facility with parents' signatures. Facility has license documentation and information properly posted and available for review in each classroom.

LPA reviewed facility records that included 6 children's records and 2 staff records. LPA observed children's and staff's records to be complete. Staff have valid CPR certificates. Last emergency drill was conducted over a year ago. Emergency drills must be conducted at least once every month and needs to be properly logged and documented.

Continued on Page 2..
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2022
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3


Document Has Been Signed on 06/16/2022 05:06 PM - It Cannot Be Edited

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: JOBTRAIN, INC CHILD DEV CTR
FACILITY NUMBER: 414000538

DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 06/16/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
CCR
101174(d)(2)
Disaster and Mass Casualty Plan
(d) Disaster drills shall be conducted at least every six months. (2) The drills shall be documented. This documentation shall be kept in the child care center for at least one year.

This requirement is not met as evidenced by:
Deficient Practice Statement
1
2
3
4
Based on record review, the licensee did not comply with the section cited above as last emergency drill was over a year ago, which poses a potential health, safety or personal rights risk to persons in care.
POC Due Date: 06/30/2022
Plan of Correction
1
2
3
4
Facility will do an emergency drill and document the drill.

Site Supervisor will email a copy of documented emergency drill to LPA Tapia-Mandujano.
Section Cited
Deficient Practice Statement
1
2
3
4
POC Due Date:
Plan of Correction
1
2
3
4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 06/16/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 06/16/2022
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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066
FACILITY NAME: JOBTRAIN, INC CHILD DEV CTR
FACILITY NUMBER: 414000538
VISIT DATE: 06/16/2022
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
26
27
28
29
30
31
32
Page 2 continued...

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 facilty is currently not providing Incidental Medical Services – IMS. 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 observed in areas evaluated, according to California Title 22, Health and Safety Code of Regulations and cited on 809D.


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

Exit interview conducted and report was reviewed with Site Supervisor, Rosa Ayala.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/16/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/16/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3