414001790-3-20-2025-05-CC-LTMO-DEXRSQ-20250320131706

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001790
Report Date: 03/20/2025
Date Signed: 03/20/2025 01:17:18 PM

Document Has Been Signed on 03/20/2025 01:17 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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	IHSD, INC-MAGNOLIA CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	414001790
ADMINISTRATOR/ DIRECTOR:	MERLO, STEPHANIE		FACILITY TYPE:	850
ADDRESS:	1425 BAY ROAD		TELEPHONE:	(650) 323-1443
CITY:	EAST PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY: 60	TOTAL ENROLLED CHILDREN: 60	CENSUS: 49	DATE:	03/20/2025
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME VISIT/ INSPECTION BEGAN:	09:00 AM
MET WITH:	Irma Anorve Lopez		TIME VISIT/ INSPECTION 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	On March 20th, 2025 at approximately 9AM, Licensing Program Analyst (LPA) Tapia-Mandujano conducted an unannounced annual inspection. LPA met with Site Supervisor, Irma Anorve Lopez and explained the purpose of the inspection. Present in the facility are Site Supervisor and 11 staff supervising a total of 49 preschool age children. All adults working in the facility are fingerprint cleared and are associated through the main administrative facility. Facility is currently operating within teacher to child ratio on this date. Facility operates Monday-Friday from 8am-4pm, year round with periodic breaks. Facility is licensed in Rooms A, B, and C. LPA conducted a health and safety inspection and observed classrooms to be clean and equipped with age-appropriate toys and materials. Storage for children's belongings are located inside each classroom, labeled with each child's individual names. LPA observed facility has an installation of a fire alarm system throughout the building as well as a fully charged, fire extinguisher in each classroom. The building has multiple smoke and carbon monoxide detector installed as well as emergency kits with first aid materials and emergency contact information. Medication is stored appropriately, inaccessible to enrolled children and maintained with proper documentation. LPA observed that all children present were signed in electronically that has captured signatures of authorized person. Facility has license documentation and information properly posted and available for review in each classroom. All poisons, cleaning solutions and hazardous materials are stored inaccessible to children in off limit areas or facility high shelves. Facility offers breakfast, lunch, and snack through Chefables. Menus are posted in each classroom. Facility offers water in each classroom that is refilled through water faucets that have been tested for lead. Water is available to children indoors and outdoors. Outdoor area appears to be clean and orderly. There are a variety of outdoor equipment that are in good working condition. Facility has added a new outdoor area that has not been approved by department (Type B deficiency issued). Continued on Page 2…

Marie Rodriguez	TELEPHONE: (650) 732-0619
Leslit Tapia-Mandujano	TELEPHONE: 650-266-8800
	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

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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Document Has Been Signed on 03/20/2025 01:17 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: IHSD, INC-MAGNOLIA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 414001790
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 03/20/2025

DEFICIENCIES & PLANS OF CORRECTION (POCs)

Section Cited

CCR

101173(c)

(c) Any proposed changes in the plan of operation that affect services to children shall be subject to departmental approval prior to implementation and shall be reported as specified in Section 101212. This requirement is not met as evidenced by:
	Deficient Practice Statement
1 2 3 4	Based on observation andi nterview, the licensee did not comply with the section cited above as the facility added another yard that has not been approved by department which poses a potential health, safety or personal rights risk to persons in care.
	POC Due Date: 04/04/2025
	Plan of Correction
1 2 3 4	Facility will submit paperwork required to approve new area, and facility agrees that this outdoor area will not be used until it has been aprroved by the department.

Section Cited


	Deficient Practice Statement
1 2 3 4
	POC Due Date:
	Plan of Correction
1 2 3 4

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

Marie Rodriguez	TELEPHONE: (650) 732-0619
Leslit Tapia-Mandujano	TELEPHONE: 650-266-8800
	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

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
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: IHSD, INC-MAGNOLIA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 414001790
	VISIT DATE: 03/20/2025

NARRATIVE

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LPA reviewed facility records that included 7 children's records and 7 staff records. LPA observed children's and staff's records to be complete. At least one staff have an up-to-date CPR & First Aid certificate. All staff have up to date Mandated Reporter Certificate. Last emergency drill was conducted 02/2025. Emergency drills are conducted at least once every six months and are properly logged and documented.

To improve the quality and value of the new inspection process, a survey may 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 CARE tools, please send email inquiries 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/inspection-process.

Facility was informed that as of 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.

Director is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

Director was reminded that all adults 18 and over, including employees and volunteers, except as specified in Health and Safety Code section 1596.871, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day for a maximum of 5 days or, if the penalty is for a repeat violation, for a
maximum of 30 days per person will be assessed if this regulation is violated.

Continued on Page 3...

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

LIC809 (FAS) - (06/04)

Page: 3 of 4

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT (Cont)

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CC RO, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: IHSD, INC-MAGNOLIA CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 414001790
	VISIT DATE: 03/20/2025

NARRATIVE

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Assembly Bill (AB) 2370, Chapter 676, Statutes of 2018, requires all licensed Child Care Centers (CCCs) constructed before January 1, 2010, to test their water (used for drinking and food preparation) for lead contamination before January 1, 2023, and then every 5-years after the date of the first test. For child care center licenses issued after July 1, 2022, the licensee shall test their water for lead within 180 days of licensure pursuant to Written Directives section 101700 (PIN 21-21.1-CCP).

LPAs verified that the lead testing was completed in accordance to the Written Directives outlined in PIN 21-21.1-CCP. Facility does not have any lead exceedances of 5.5ppb and is in compliance with the Written Directives.

This facility provides Incidental Medical Services – IMS. LPAs reviewed storage of “medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see PIN 22-02-CCP. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice) or (800) 514-0383 (TTY) and link to publication. Commonly Asked Questions about Child Care Centers and the ADA are available at: https://www.ada.gov/resources/child-carecenters/.

Director was informed of the MyChildCarePlan.org website; a consumer education website that helps families obtain child care by connecting them to child care providers and Resource and Referral Agencies (R&Rs) throughout California.

Based on today's inspection, deficiencies were observed, according to California Title 22, Health and Safety Code of Regulations.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with Site Supervisor, Irma Anorve Lopez.

SUPERVISOR'S NAME: Marie Rodriguez	TELEPHONE: (650) 732-0619
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/20/2025

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/20/2025

LIC809 (FAS) - (06/04)

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