414000636-6-6-2023-05-CC-LGOZ-CSJSPS-20230606140337

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000636
Report Date: 06/06/2023
Date Signed: 06/06/2023 02:03:49 PM

Document Has Been Signed on 06/06/2023 02:03 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 (PS)		FACILITY NUMBER:	414000636
ADMINISTRATOR:	MCLAUGHLIN, MICHELE		FACILITY TYPE:	850
ADDRESS:	797 REDWOOD SHORES PARKWAY		TELEPHONE:	(650) 780-7322
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94065
CAPACITY:	40	CENSUS: 0	DATE:	06/06/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:30 AM
MET WITH:	Christina Harvey, Michele Mclaughlin		TIME COMPLETED:	12:00 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 6/6/2023 at 9:30AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Lead Teacher, Cristina Harvey. Purpose of inspection was explained and was for an Unannounced, Annual Random inspection. Facility is licensed to operate preschool-age program, located next to Sandpiper Elementary School. Director, Michele Mclaughlin arrived during inspection. Present was the director and 5 staff. Staff' members present have criminal record clearances on file. Per director, preschool program is closed today for summer break. Day and hours of operation Mon, Tues, Thurs, Fri, 8:30AM- 2:00PM. Wed, 8:30AM-12:00PM. Program operated 10- month schedule. Program utilizes one classroom and the outdoor play area. LPA inspected facility, indoors and outdoors, with director for health and safety hazards. At 9:40AM., LPA observed the following: Classroom was clean, orderly, with age-appropriate playthings available. Floor/ground surfaces were free of any obstructions. LPA observed labeled cubbies for storage of children's belongings. Furniture, books, blocks inspected were free of sharp corners or splinters. Classroom is equipped with child- sized tables and chairs for snack and seated activities. Children’s bathrooms are maintained clean with fixtures (4 toilets, 6 sinks) in operating condition. Staff bathroom is located separately. Classroom has acceptable ventilation and lighting. Disinfectants, toxins, and cleaning compounds have been stored inaccessible to children. Outlets and trash bins have coverings installed. Facility has built-in smoke detector, functioning carbon monoxide detector, telephone service, and two fully charged fire extinguishers: 2A:10BC. First aid kit was reviewed and was fully stocked. At 10:05AM, 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 available for children. For water services, fountains are accessible to children, outside and inside. (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 (PS)	FACILITY NUMBER: 414000636
	VISIT DATE: 06/06/2023

NARRATIVE

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At 10:30AM LPA reviewed facility records including five children’s files and six personnel files. Files reviewed contained staff's: Notice of Employee Rights (LIC9052); Education Verification; Proof of Required Immunization; Updated Mandated Reporter Training Certification (AB1207); and Personnel Record (LIC501).

Files reviewed contained children's: Consent for Emergency Medical Treatment (LIC627); Immunization Records, Identification and Emergency Information (LIC700); Personal Rights (LIC613A); and Notification of Parent’s Rights (LIC995).

Staff member had their current ‘Cardiopulmonary Resuscitation and First Aid’ certification, which expires on: 5/2024.

Emergency disaster drill are conducted on-site, with the last drill completed on 5/18/2023, and is properly logged.

LPA observed required posting in facility, including the: Facility License; Notice of Parent’s Rights (PUB394); Emergency Disaster Plan (LIC610); Earthquake Preparedness Checklist; Lunch Menu; and Child Passenger Safety Laws (PUB369).

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

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

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. (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)

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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 (PS)	FACILITY NUMBER: 414000636
	VISIT DATE: 06/06/2023

NARRATIVE

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

This report must be made available in the facility for public review. Notice of site visit was provided and must remain posted for 30 days. Director 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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