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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001575
Report Date: 09/12/2019
Date Signed: 09/12/2019 11:36:10 AM

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 - SUNSET RIDGE CHILDREN'S CENTERFACILITY NUMBER:
414001575
ADMINISTRATOR:CYNTHIA USSERYFACILITY TYPE:
850
ADDRESS:340 INVERNESSTELEPHONE:
(650) 738-7465
CITY:PACIFICASTATE: CAZIP CODE:
94044
CAPACITY:24CENSUS: 14DATE:
09/12/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:40 AM
MET WITH:Cynthia UsseryTIME COMPLETED:
11:50 AM
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Licensing Program Analyst (LPA) Andrea Medlin met with staff for this random annual licensing visit today. Purpose of the visit explained. There are 14 children present. Facility meets teacher-child ratio today. Physical plant toured, including the classroom 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 a carbon monoxide (CO) detector in the facility. Children's bathroom inspected; all toilets and hand washing facilities are in safe and sanitary operating condition. Separate staff bathrooms are available. No pools, spas, hot tubs, fish ponds, or similar bodies of water are present. Per staff, 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 classroom. Classroom is set up for child care, and furniture and equipment for children is present. If a child is taking medication, it is stored in an inaccessible location to children. Center provides meals and snacks; a sample menu is available and posted. First aid supplies are available. Sick children will be separated from the group and wait for parents to pick up. Outdoor play area inspected for health and safety hazards. The areas around and under high climbing equipment is cushioned with soft rubber. Outdoor activity spaces are enclosed by fences and surfaces are free of hazards. Facility has posted all the required licensing forms. LPA reviewed staff and children's files. In the files that were reviewed, all children had current immunization records and Parent's Rights (LIC 995) on file. Staff have verification of the required staff immunizations.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019
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 - SUNSET RIDGE CHILDREN'S CENTER
FACILITY NUMBER: 414001575
VISIT DATE: 09/12/2019
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Incidental Medical Services (IMS) policy discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding ADA is 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. Facility informed that effective 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. LPA reviewed with director the Mandated Child Abuse Reporting training as compliant with AB 1207. As of January 1, 2018 all child care staff are required to complete Mandated Child Abuse Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

LPA advised staff to frequently visit the Department's website at www.ccld.ca.gov for licensing regulations and updates. Facility may email childcareadvocatesprogram@dss.ca.gov to be added to the email distribution list for licensing updates.

This report is reviewed with director and a copy of this report must be made available for public review upon request.

Notice of site visit posted and shall remain posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea MedlinTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/12/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/12/2019
LIC809 (FAS) - (06/04)
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