414001616-10-25-2019-05-CC-AMEN-BHAVBP-20191025161752

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001616
Report Date: 10/25/2019
Date Signed: 10/25/2019 04:17:57 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:	IHSD, INC-BADEN INFANT CENTER		FACILITY NUMBER:	414001616
ADMINISTRATOR:	SOSA, MERY		FACILITY TYPE:	830
ADDRESS:	825 SOUTHWOOD DRIVE		TELEPHONE:	(650) 737-5748
CITY:	SOUTH SAN FRANCISCO	STATE: CA	ZIP CODE:	94080
CAPACITY:	9	CENSUS: 3	DATE:	10/25/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	02:25 PM
MET WITH:	Mery Sosa		TIME COMPLETED:	04:30 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 Analyst (LPA) Andrea Medlin met with director for this random annual licensing visit. Purpose of visit explained. There are 3 infants present during the visit. Days and hours of operation: Monday, Tuesday, Thursday, and Friday 7:45AM-3:45PM; every second Wednesday of the month 7:45AM-1:15PM. Physical plant toured to inspect for health and safety hazards. The facility has a fully charged fire extinguisher that meets the minimum requirements, smoke detector, and a carbon monoxide detector (CO) in the facility. Facility is licensed as a combination center which includes: infant and preschool programs. The infant program is located at the South San Francisco Adult School/Baden High school campus and occupies one portable classroom. Facility is adequately furnished with age appropriate toys, furniture, cribs, changing tables, and equipment. Separate staff bathrooms are available. Outdoor play area inspected for health and safety hazards; areas around and under climbing equipment is cushioned with soft rubber. If breast milk is provided by parents, it is stored appropriately in the refrigerator in an individualized labeled trays and each bottle is labeled. Facility provides formula and diapers for children. Sinks are present in the classroom as well as located near the changing tables. No pools, spas, hot tubs, fish ponds or similar bodies of water are present. Disinfectants, cleaning solutions, poisons, and toxics are inaccessible to children. Per staff, there are no firearms or weapons on site. Portable is set up for child care and furniture and equipment for children is present. Adequate first aid supplies are available. Facility has posted all the required licensing forms in a prominent accessible location. LPA reviewed staff and children files. In the infant files that are reviewed, each has verification of immunizations, Parent's Rights, and Infant Care Plan on file. In the staff files reviewed, all staff have current Pediatric First Aid and CPR training, the required staff immunizations, verification of the appropriate educational requirements, and have verification of the mandated child abuse reporter training as compliant with AB1207. (Continued on next page 809-C)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

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: IHSD, INC-BADEN INFANT CENTER	FACILITY NUMBER: 414001616
	VISIT DATE: 10/25/2019

NARRATIVE

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Incidental Medical Services (IMS) policy discussed. 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.

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 Leung	TELEPHONE: (650) 266-8867
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/25/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/25/2019

LIC809 (FAS) - (06/04)

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