414001790-9-30-2019-05-CC-CINO-BGHRV9-20190930132109

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001790
Report Date: 09/30/2019
Date Signed: 09/30/2019 01:21:14 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-MAGNOLIA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	414001790
ADMINISTRATOR:	MATTIE CRAMER		FACILITY TYPE:	850
ADDRESS:	1425 BAY ROAD		TELEPHONE:	(650) 323-1443
CITY:	EAST PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY:	60	CENSUS: 52	DATE:	09/30/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Site Supervisor, Mattie Cramer		TIME COMPLETED:	01:35 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), Cindy Interiano conducted an Annual/Random inspection and met with Site Supervisor, Mattie Cramer. Purpose of the inspection was explained to Site Supervisor. Program operates in Room ‘A,’ Room ‘B,’ and Room ‘C,’ M-F, 8a-4p, year-round with periodic breaks throughout the year. Present during the inspection was Site Supervisor and 8 staff supervising 52 PreK children. Program is in compliance with Staff-Child ratios. LPA inspected facility indoors and outdoors for Health and Safety Hazards. Classroom has age appropriate toys and equipment. Cubbies, hooks, and bins are used to store children’s belongings. Classrooms share a restroom, which as 4 toilets and 2 sinks. Additional sinks are in the classrooms. Restroom is kept clean, in good repair, and maintained with adequate supplies. Staff use separate restrooms, which are maintained ‘off limits’ to children. Program provides snacks and meals and food is delivered daily by food vendor ‘Chefables.’ Facility has a fully supplied Emergency Kit and Emergency supplies, which are maintained inaccessible to children. Classroom has an industrial fire alarm system, an additional smoke and carbon monoxide detector, and a Fire Extinguisher. Last Emergency Disaster drill was conducted on 09/19/19 and is properly logged. Discipline policy is mainly redirection. Napping equipment is properly stored. Outdoor play area is kept clean and free of debris and hazardous items. Staff conduct a daily sweep prior to the children going out for outdoor play. All outdoor toys and equipment are age appropriate and in good repair. Drinking water is readily available outdoors and indoors. All mandatory postings are posted in the classroom, including menus and waivers. Facility is using an Electronic Sign in/out program called ‘Child’s Plus,’ which captures Guardian’s signature and sign in/out times. Program was checked and is current. Staff and children’s files were reviewed and are complete and up-to-date. All staff have required immunization and current CPR card on file. See Page 2. . .

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

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-MAGNOLIA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 414001790
	VISIT DATE: 09/30/2019

NARRATIVE

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Page 2. . .

During inspection,

*Incidental Medical Services (IMS) policy was discussed.
*Site Supervisor was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Site Supervisor was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare.
*Site Supervisor was reminded about Mandated Reporter Training available on CCLD website (www.ccld.ca.gov or www.mandatedreporterca.com)
*Site Supervisor was advised of the new Lead Bill (effective 01/01/19), requiring Facilities to distribute a two-page flyer to Guardians with information on lead poisoning facts
*Site Supervisor was reminded about the Provider Information Notices (PINs) on CCLD website.

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

>This report and rights to comment and appeal were discussed with Site Supervisor. This report must be available in the facility for public review. Notice of site inspection was posted.
Site Supervisor was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 09/30/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/30/2019

LIC809 (FAS) - (06/04)

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