414001616-10-20-2022-05-CC-AMEN-CKDRPW-20221020131238

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001616
Report Date: 10/20/2022
Date Signed: 10/20/2022 01:12:44 PM

Document Has Been Signed on 10/20/2022 01:12 PM - It Cannot Be Edited

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: 7	DATE:	10/20/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Mery Sosa		TIME COMPLETED:	01:15 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 facility representative for this required annual licensing visit today. Purpose of visit explained. Physical plant toured to inspect for health and safety hazards. There are 7 infants present during the visit. Facility meets teacher/infant ratio today. Days and hours of operation: Monday-Friday 8:00AM-4:00PM. 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. There are fire extinguishers, smoke detectors, and a carbon monoxide (CO) detector in the classroom. Facility is adequately furnished with age appropriate toys, furniture, cribs, changing tables, and equipment. A separated napping area with cribs is available. Furniture and equipment is in good condition, free of sharp, loose, or pointed parts. Separate staff bathrooms are available. Outdoor play areas inspected for health and safety hazards and are completely fenced, areas around and under climbing equipment is cushioned with soft rubber to absorb falls. Shade is provided by a tarp overhead in the outdoor play area. If breast milk is provided by parents, it is stored appropriately in the refrigerator in a individualized labeled tray. Facility provides formula, baby food, diapers, wipes, snacks, and all meals. A sample menu is available and posted. A sink is present in the classroom and located near a changing table. 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 director, there are no firearms or weapons on site. Adequate first aid supplies are available. Facility has posted all the required licensing forms in a prominent accessible location. LPA reviewed staff and children's files. In the files that were reviewed, all have complete files. Staff have verification of the required staff immunizations: measels (MMR) and pertussis (TDap); staff have verification of the required mandated child abuse reporting training as compliant with AB1207. (Continued on next page 809-C)

SUPERVISOR'S NAME: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

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: 10/20/2022

NARRATIVE

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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.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.

This report is reviewed with facility representative 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: Daniel J Oquendo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Andrea Medlin	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/20/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/20/2022

LIC809 (FAS) - (06/04)

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