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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001224
Report Date: 11/15/2019
Date Signed: 11/15/2019 12:55:50 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:CITY OF PACIFICA - VALLEMAR CHILD CARE CENTERFACILITY NUMBER:
414001224
ADMINISTRATOR:GRETCHEN HAYESFACILITY TYPE:
850
ADDRESS:377 REINA DEL MARTELEPHONE:
(650) 738-7466
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:25CENSUS: 11DATE:
11/15/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
11:10 AM
MET WITH:Gretchen HaysTIME COMPLETED:
01:15 PM
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On 11/15/19 at 11:10 am, Licensing Program Analyst (LPA) April Cowan met with Staff members Bonnie and Tara for a random annual inspection. Director was not present. Per staff, she was on her way to facility. Purpose of the inspection was explained and LPA was granted access. Staff members took children out for play and LPA remained to inspect facility while waiting for director. At 11:45, director, Gretchen Hayes, arrived. In the facility are Director, 3 staff, and 11 Preschoolers. Facility is operating within capacity and in compliance with staff child ratio on this day. Facility operate day care from Monday to Friday from 9:00 AM to 12:00 PM.

With director, LPA inspected the day care room and play yard. LPA observed facility has working smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone on site. All cleaning solutions, poisons and other chemicals dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility is floor is in good repair and free of any hazards. There is first aid supplies available in classroom. All hand washing facilities are in working condition with proper sanitation in place. All storage containers for solid waste are in good repair and have proper lids. All food is stored in a properly manner and has lids to avoid contamination. Facility provides 1 snack per day. Play yard is free of hazards. There is sufficient cushion material in the play yard to help absorb the impact of falls.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
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: CITY OF PACIFICA - VALLEMAR CHILD CARE CENTER
FACILITY NUMBER: 414001224
VISIT DATE: 11/15/2019
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At 12:30 PM, LPA reviewed the facility records. LPA observed that facility has sign in/out sheet. Facility performed last emergency drill 9/18/19 and is properly logged. Facility has license and all other required documents posted and visible for the public view (Personal Rights, Parents Rights Poster, Emergency Plan, Menu, Daily Program, and Car Seat Law). LPA reviewed 5 random children's files Children's files are complete with all required documents. 3 staff files were reviewed and are complete. There are menus posted at least one week in advance and are visible to the child's authorized representative.
Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificates on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

>No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.


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.


An exit interview was conducted with Gretchen Hayes, director, including but not limited to Appeal Procedures, Site Visit, and Initial Appeal Rights.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 11/15/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/15/2019
LIC809 (FAS) - (06/04)
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