414000614-4-22-2021-05-CC-LGOZ-C2C2GX-20210422172353

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000614
Report Date: 04/21/2021
Date Signed: 04/22/2021 05:23:59 PM

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:	IHSD, INC-EAST PALO ALTO HEAD START CENTER		FACILITY NUMBER:	414000614
ADMINISTRATOR:	MATTIE CRAMER		FACILITY TYPE:	850
ADDRESS:	1385 BAY ROAD		TELEPHONE:	(650) 323-2949
CITY:	EAST PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY:	64	CENSUS: 17	DATE:	04/21/2021
TYPE OF VISIT:	Case Management - Licensee Initiated	ANNOUNCED	TIME BEGAN:	01:45 PM
MET WITH:	Education Manager, Jennifer Pifeleti		TIME COMPLETED:	02:45 PM

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THE FOLLOWING INSPECTION WAS CONDUCTED VIA TELE INSPECTION DUE TO THE COVID-19 HEALTH EMERGENCY.

On 4/21/2021 at 1:45P.M. Licensing Program Analyst (LPA), Luis J. Gomez met with Education Manager, Jennifer Pifeleti. Purpose the inspection was explained and is a case management inspection to review changes made to the physical plant. Present is the director, six staff and 17 children. All children present are preschool age. Application was received on 1/21/2021. Classroom C has been converted into two, stand-alone classrooms, C1 and C2, including one hallway area. Per Education Manager, facility total capacity and square footage has remained the same. Classrooms C1 and C2 will be used for Early Head Start, children ages 2-3 years old. Day and hours are Monday- Friday: 8:00A.M.-4:00P.M. Program will operate year-round. LPA inspected, indoors and outdoors, for Health and Safety Hazards.

LPA observed the following: Classrooms C1 and C2 are clean, orderly and have a variety of age appropriate toys, blocks and supplies for the children. Furniture and equipment inspected are in good repair. There are several children’s tables and chairs for activities. Classrooms are equipped with dramatic play areas, art stations and carpeted reading area. Classrooms have fully charged fire extinguisher (2A:10BC) located at the exits and smoke/ carbon monoxide detector. Children’s bathroom, located in the hallway, is in working order and properly stocked with soap, stepping stools, toilet tissue and paper towels. LPA observed children's bathroom has three toilets and two sinks. Staff use separate restrooms, located in the hallway. Accessible outlets and trash bins have been properly covered. Stackable napping cots are stored in each classroom. Per Education Manager, patio area, located outside C2, will be used primarily for teacher guided actives. Patio Area is free of hazards or dangerous conditions. Hallway is equipped with refrigerator and additional cabinets for added storage. Program's snack and meals are delivered daily.

(CONT. on 809C)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/21/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/21/2021

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: IHSD, INC-EAST PALO ALTO HEAD START CENTER	FACILITY NUMBER: 414000614
	VISIT DATE: 04/21/2021

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At 2:09P.M., LPA inspected new Side Yard, and remodeled Main Yard. Outdoor play areas are completely enclosed with tall fencing. Two large tarps have been installed for adequate shading. There is a turf grass area, sand boxes and large blocks for the children. All equipment inspected appears to be in good repair. Drinking water is readily available for children with the use of movable containers and paper cups. Safety divider has been installed between Patio Area and Side Yard to prevent access. Main Yard is equipped with a large slide and climbing wall. A rubber padded surface has been installed throughout the outdoor play areas for added safety. Outdoor play areas are free of hazards or dangerous conditions.

Total area for classrooms C1 and C2 is 1,190 sq. ft and total number bathroom fixtures (2) and toilets (3). Classrooms, C1 and C2 meet requirements to accommodate the requested capacity of 16 children, (8 children per room).

Side Yard total area measure 980 sq. ft. Total area divided by 75 sq. ft. per child. Side Yard can accommodate groups of 13 children or less.

Prior to approval of physical plant changes, facility must:

-Submit Fire Clearance Approval (STD 850)

-Obtain storage for children’s belongings

-Install padding on exposed pillar in classroom: C2

-Post all required posting in facility hallway

-Obtain first aid kit

-Finish set up of classroom, C2 and Hallway

No deficiencies were cited against the facility under CCR, Title 22. 12 Ch. 1.

This report must be available in the facility for public review. Licensee was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) -26-8864
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 04/22/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/22/2021

LIC809 (FAS) - (06/04)

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