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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001067
Report Date: 08/01/2019
Date Signed: 08/01/2019 04:57:14 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:CITY OF PACIFICA VALLEMAR CHILDREN'S CENTERFACILITY NUMBER:
414001067
ADMINISTRATOR:PATTERSON, M./WRIGHT, C.FACILITY TYPE:
840
ADDRESS:377 REINA DEL MARTELEPHONE:
(650) 738-7466
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:120CENSUS: DATE:
08/01/2019
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
03:15 PM
MET WITH:Gretchen Hayes, Mindy Tiet, Tracy GilbertTIME COMPLETED:
05:00 PM
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Licensing Program Analyst (LPA) Andrea Medlin met with staff, and child care supervisor, for this case management visit due to a request to increase capacity. Facility is licensed to serve school aged children on the Vallemar Elementary School campus and currently operates the school age program in portables #1, #2, #3, #4; requesting to add portable #5 for an additional 30 children. North County Fire Authority has approved the fire clearance on 7/18/19. Days and hours of operation for the school aged program: Monday-Friday 12:00PM-6:00PM. Portable #5 will be used for the preschool program: Monday-Friday 9:00AM-12:00PM. Superintendent certification is on file and this is a functioning school site, therefore facility is exempt from the following: indoor square footage, fencing, outdoor activity space, toilets, and isolation space requirements. Physical plant toured, including the areas used for the program, and outdoor play area to inspect for health and safety hazards. There are fully charged fire extinguishers that meet minimum requirements, smoke detectors, and carbon monoxide (CO) detectors present in each portable. Children's bathrooms inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. A separate staff bathroom is available. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per director, there are no firearms or weapons on site. Disinfectants, cleaning solutions, poisons and other items that are dangerous to children are inaccessible. Variety of age appropriate toys and materials for children are available in the facility. Facility provides snacks. First aid supplies are available. There are school aged outdoor play areas. The areas around and under high climbing equipment is cushioned with soft rubber. Outdoor activity space surfaces are free of hazards. Facility has posted all the required licensing forms. This facility meets the licensing requirements to increase capacity to 150 children and re-licensure is recommended and approved as of today, 8/1/2019. New license shall be posted when received. This report is reviewed with child care supervisor and a copy of this report must made be available for public review upon request.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/01/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/01/2019
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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