414001867-1-7-2020-05-CC-JSAI-BKLQBR-20200107110158

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001867
Report Date: 01/07/2020
Date Signed: 01/07/2020 11:02:09 AM

COMPREHENSIVE INSPECTION

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:	HUGS HANGOUT		FACILITY NUMBER:	414001867
ADMINISTRATOR:	PAM COHN		FACILITY TYPE:	850
ADDRESS:	500 ACACIA AVENUE, ROOM # PC-1		TELEPHONE:	(650) 465-7529
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	39	CENSUS: 37	DATE:	01/07/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:00 AM
MET WITH:	Pam Cohn		TIME COMPLETED:	11:10 AM

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 Analysts (LPAs), Jyoti Saini and Cindy Interiano, met with Director Pam Cohn to conduct an unannounced annual random inspection. Purpose of the Inspection was explained to Director. Purpose was also for an increase of capacity. Facility operates Monday-Friday, 7:30a-6:30p, year-round with periodic breaks. Facility operates in classrooms Room #1 (PC-1) and Room #2 (aka 7-H) on the Allen Elementary School site. Present is Director and 7 staff supervising 37 children. LPAs and Director inspected the facility indoors and outdoors for Health and Safety hazards. Facility is requesting an increase of capacity from 39 children (ages 2 - entry to first grade) to 69 children by adding additional Room 3 (aka 1-H). Room #3 measures out 870.40 square feet, allowing for maximum capacity of 25 PreK children. Room #1 and Room #2 were previously measured out 948.39 square feet, allowing for capacity of 27 children per room. Outdoor play area was previously measured, allowing a capacity of 80 children. See facility sketch and capacity worksheet. Facility has scheduled use of the outdoor play area and there is an approved Outdoor play waiver on file. Outdoor play area is fenced. Wood chips are used as floor cushioning underneath the play structures. All outdoor toys and equipment are age appropriate and in good repair. Drinking water is readily available outdoor via pitcher/cups that teachers bring outdoors. Each Classroom has a hand washing sink. Facility also has an approved waiver for scheduled use of the children's restroom. There are 2 restrooms: one with 3 toilets and 2 sinks, and the second restroom with 2 toilets, 1 urinal, and 2 sinks. Staff restroom is in Restroom #1 and properly labeled for Staff usage only. Program provides daily meals, all prepared in the kitchen, which is off limit to children. Each classroom is equipped with a Smoke detector, Carbon monoxide detector, and a fully charged Fire Extinguisher. Last Emergency Disaster drill was conducted on 11/01/19 and is properly logged. All mandatory postings are posted in the classroom. LPAs reviewed sign in/out sheets. LPAs also reviewed staff files which are complete. Staff files have up-to-date immunization and staff CPR training. See Page 2. . .

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Jyoti Saini	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020

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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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: HUGS HANGOUT	FACILITY NUMBER: 414001867
	VISIT DATE: 01/07/2020

NARRATIVE

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Also during the inspection,
*Incidental Medical Services (IMS) policy was discussed.
*Director was reminded about having all Staff and Volunteers provide proof of immunization against influenza, pertussis, and measles or qualifies for an exemption.
*Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare.
*Director was reminded about Mandated Reporter Training available on CCLD website
(www.ccld.ca.gov or www.mandatedreporterca.com)
*Director 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
*Director was reminded about the Provider Information Notices (PINs) on CCLD website.

Fire Inspector inspected facility on 12/31/19 and granted fire clearance for 69 with no restrictions.

Facility is now approved to use Room #3 and License will be updated allowing capacity of 69 children ages 2 to entry to first grade. Waiver for restroom and outdoor play use will be updated.

***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 Director. This report must be available in the facility for public review. Notice of site inspection was posted.
Director was advised any additional questions to call Office, M-F, 8:00am-5:00pm, 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: Jyoti Saini	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/07/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/07/2020

LIC809 (FAS) - (06/04)

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