414000691-12-10-2019-05-CC-HKAR-BJQVN9-20191210153446

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414000691
Report Date: 12/10/2019
Date Signed: 12/10/2019 03:34:54 PM

COMPREHENSIVE INSPECTION

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:	NEW HORIZONS SCHOOL-AGE CENTER		FACILITY NUMBER:	414000691
ADMINISTRATOR:	THOMPKINS, AJMIR K.		FACILITY TYPE:	840
ADDRESS:	200 SHAWNEE PASS, ROOM 4		TELEPHONE:	(650) 851-5671
CITY:	PORTOLA VALLEY	STATE: CA	ZIP CODE:	94028
CAPACITY:	40	CENSUS: 19	DATE:	12/10/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Ajmir K Thompkins		TIME COMPLETED:	03:55 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	Licensing Program Analysts (LPA) kaur met with director, Ajmir K. Thompkins, for a random annual inspection. Purpose of the inspection was explained. Present, there are 19 children with one teacher and one aide. The facility is operating within capacity and meet staff children ratio. All the personal working has criminal background clearance on file. The facility operates from room number 4 and play yard on Monday to Fridays from 12:00 PM to 6:00 PM LPA in inspected the facility with director. There are no pools, spas or other bodies of water. The facility is free of any hazard and in good repair with proper temperature and ventilation. There is working telephone, fully charged fire extinguisher, carbon monoxide available in the facility. All the furniture and equipment is in good condition and free of sharp or loose parts. All the medications, cleaning supplies and other chemicals are stored inaccessible to the children. The bathrooms and sinks are free of any toxins, safe and sanitary operating conditions. Facility provides the snack only. The food storage area is clean and free of any toxic or contamination. All the food is in good condition and at proper temperature. Play yard is in good repair, free of sharp or loose parts, free of hazards and with sufficient rubber surface under the play structure. There are drinking water sources available indoor and outdoor. At 2:00PM LPA reviewed staff's and children's files. Facility has staff member with valid CPR and pediatric first aid training until 08/2021. Per director, last emergency and fire drill was conducted on 12/03/2019. Facility has record of a fully qualified teacher designated to act in director's absence. Each child's file identification record, including authorized representative's information. Facility has complete record of sign in and sign out by authorized pick up person. See next page for continuation .......

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

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: NEW HORIZONS SCHOOL-AGE CENTER	FACILITY NUMBER: 414000691
	VISIT DATE: 12/10/2019

NARRATIVE

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The director 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 was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare

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 publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

LPA reviewed AB 1207 with the Licensee. As of January 1, 2018 all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA discussed the effects of lead exposure with the director and a handout was provided. LPA encourages the director to frequently visit our 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.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/10/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/10/2019

LIC809 (FAS) - (06/04)

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