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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414001655
Report Date: 03/02/2020
Date Signed: 03/02/2020 12:22:35 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:STELLA PICCOLOFACILITY NUMBER:
414001655
ADMINISTRATOR:LEANNE RUNYANFACILITY TYPE:
850
ADDRESS:65 TOWER ROAD, ROOM 8TELEPHONE:
(650) 804-5923
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:21CENSUS: 0DATE:
03/02/2020
TYPE OF VISIT:Case Management - Licensee InitiatedUNANNOUNCEDTIME BEGAN:
08:30 AM
MET WITH:Director, Leanne RunyanTIME COMPLETED:
12:30 PM
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Licensing Program Analyst (LPA) Luis J. Gomez met with Leanne Runyan, to conducts an announced case management inspection for a temporary room change. The purpose of the inspection is explained. There are no children or staff present. The case management inspection is related to a temporary (1-month), Room Change application, submitted by the director, on 12/16/2019. Director requests a temporary room change into Room #1, in the infant building, located at 69 Tower Road. LPA performed classroom measurements and inspected space for health and safety hazard.

Classroom #1 is clean, orderly and has a variety of age appropriate books, games and toys for the children. There are child size tables and chairs available for he children. Children bathroom, located in the classroom, is equipped with supplies. The facility license and required posters are located next to the door. All cleaning product, detergents and supplies are made inaccessible. Director had a first aid kit located in

The measurement total of classroom #1, is 1155.37 sq. ft. with an encumbered space of 287.515 sq. ft. Total indoor place is 867.855 sq. ft. The total capacity allowed is 15 children. LPA observed classroom is equipped with four sinks and one toilets. Per licensee, the children's outdoor play area will remain the same.

During today’s inspection, Director submitted updated LIC 610 and LIC 200

The following item must be completed prior licensure:

· Fire Clearance approval must be received by CCL

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For a quarterly update on Licensing information, go to the CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/02/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/02/2020
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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