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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001160
Report Date: 05/30/2019
Date Signed: 05/30/2019 02:46:29 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:FOOTSTEPS@NESBITFACILITY NUMBER:
414001160
ADMINISTRATOR:NICHOLS, CNOTRAFACILITY TYPE:
840
ADDRESS:500 BIDDULPH WAYTELEPHONE:
(650) 592-0522
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY:160CENSUS: 34DATE:
05/30/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Cnotra NicholsTIME COMPLETED:
03:00 PM
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An annual comprehensive inspection was conducted today. This program is located on the campus of Nesbit Elementary/Middle School. Analyst toured the facility building and grounds, conducted an evaluation of the physical plant, and reviewed children, staff and facility records. A review of staff records during today’s visit indicates that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. The program operates Monday through Friday from 7 AM to 6:15 PM.

The following was observed today:
Waivers on file are for shared outdoor space with the elementary school and electronic sign in out
Current facility director/site supervisor is Cnotra Nichols
Current designated applicant for the license is Karen Haas-Foletta
Current rooms used for care are the main room (A,B), the multipurpose room on the elementary school campus, and rooms 1,6,7,22,23,28,29,30,31,34,42,44,45,46,47,48.

The following items were reviewed as part of today's visit: Care and Supervision of the Children, Child Discipline Procedures (talking/redirection/behavior strategies used), Emergency Evacuation Procedures (smoke and carbon monoxide detectors present and in working order), Medication Policies, Isolation of Sick Children, Food Service, Transportation (none provided except during summer rented buses are used for field trips), Parents Rights, and Reporting Requirements. Bathrooms for school age children are located in rooms A,B and on the school campus. Supervision of school age children coming and going from the bathrooms and at the bathrooms on the elementary school site is achieved by use of the buddy system.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
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 2
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: FOOTSTEPS@NESBIT
FACILITY NUMBER: 414001160
VISIT DATE: 05/30/2019
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 The outdoor activity space is the fenced yard attached to the portable, the kindergarten playground, and when school is out the elementary school playground. Supervision of school age children using a functioning school site public playground is achieved by stationing of children in all areas where children are playing. Children are signed in to the facility by facility staff and out of the facility by authorized representatives. Posting requirements for site visits were discussed as well as AB 633 requirements. Current forms and Title 22 Regulations can be obtained through the internet at www.ccld.ca.gov. Staff immunization are on file. Director was reminded 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. Influenza Declarations were also reviewed. Director was advised of Pesticides training. For More information about changes to the Healthy Schools Act, templates, or articles, you can inspect the DPR website at:
https://apps.cdpr.ca.gov/schoolipm/childcare/training/main.cfm . Director was informed about the Provider Information Notices (PINs) on CCLD website. Director was reminded of Mandated Reporter Training available on CCLD website. Training must be renewed every two years.
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 The following items need to be completed and returned to Licensing by 7/21/19:-PERSONNEL REPORT (LIC 500)-EMERGENCY DISASTER PLAN (LIC 610

No deficiencies cited today. "NOTICE OF SITE VISIT" DOCUMENT WAS POSTED ADJACENT TO THE MAIN ENTRY DOORWAY AND VISIBLE TO PARENTS.

SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/30/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/30/2019
LIC809 (FAS) - (06/04)
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