414001932-11-19-2019-05-CC-MROZ-BJ3VJM-20191119152859

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414001932
Report Date: 11/19/2019
Date Signed: 11/19/2019 03:29:05 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:	PFS - EARLY LEARNING CDC (PS)		FACILITY NUMBER:	414001932
ADMINISTRATOR:	VILLALPANDO,ADRIANA		FACILITY TYPE:	850
ADDRESS:	24 SECOND AVENUE		TELEPHONE:	(650) 403-4300
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94401
CAPACITY:	48	CENSUS: 40	DATE:	11/19/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	11:30 AM
MET WITH:	Adriana Villalpando		TIME COMPLETED:	04:00 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) Marie Rodriguez conducted an unannounced Annual Random inspection. LPA met with staff and explained purpose of inspection. Site Director Adriana Villalpando was notified and arrived a short time later. Center is dually licensed with PFS-Early Learning CDC - Infant Center #414001932, an infant program on site. Present in center were the Site Director and the following: Room 3A had 2 teachers and 7 children (toddlers); Room 3B had 1 teacher and 4 children (toddlers); Room 1 had 2 teachers and 15 children (preschool); and Room 2 had 2 teachers and 14 children (preschool). Center is operating within capacity limits and in compliance with staff to child ratio. Hours of operation are Monday to Friday from 7:00am to 5:30pm. LPA toured and inspected center with Site Director. There are no bodies of water, firearms, or weapons on the premises. There are four classrooms in the center which are in good condition with proper temperature and ventilation and are free of any hazards. Furniture in classrooms are in good repair. Classrooms have age appropriate toys and equipment. Toddler classrooms 3A and 3B share a bathroom with two toilets, one sink, and a changing table. Preschool classrooms 1 and 2 share a bathroom with three toilets. There are two sinks in each classroom that are outside of the bathroom. Bathrooms appear to be clean, in good repair, and free of any hazards. There is a separate bathroom for staff usage on the premises. The outdoor play area is fenced for supervision with age appropriate toys and equipment in good condition and with sufficient cushioning underneath. There is also an indoor gross motor room with age appropriate toys and equipment inside that are in good condition. All required postings and waiver are posted on the bulletin board in the hallway between the toddler and preschool classrooms and inside each classroom. Center provides catered breakfast, lunch, and snacks by an outside vendor. A menu is posted for the month. Drinking water is available for children indoor and outdoors. Kitchen is clean and free of any toxins or contamination. All storage containers for solid waste have a proper lid. All cleaning products, chemicals, and toxins are inaccessible to children. Napping equipment are properly stored when not in use. Bedding for mats are stored when not in use and are brought home at the end of each week for cleaning. (Continued on second page)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019

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: PFS - EARLY LEARNING CDC (PS)	FACILITY NUMBER: 414001932
	VISIT DATE: 11/19/2019

NARRATIVE

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(Continued from first page)

Last emergency drill was conducted in October 2019. Emergency drills are conducted every couple of months and are properly logged. The center has a complete record of sign-in/out sheets by authorized pickup person. There is a working fire alarm system, a fully charged fire extinguisher, a smoke and carbon monoxide detector, and a working telephone available on site.

Eight children records reviewed were complete. All children have a record of emergency identification information on file. Four staff records reviewed were complete. All staff have a criminal record clearance on file. Staff have current Pediatric First Aid/CPR certificates and Mandated Reporter and Pesticides training certificates on file.

During inspection,

Director was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.662.
Director was reminded about Mandated Reporter Training. Training must be completed by staff every two years. (Website: www.mandatedreporterca.com).
Director was reminded about the Provider Information Notices (PINs) on CCLD website.

No deficiencies cited today.

This report was reviewed and discussed with Site Director Adriana Villalpando. A copy of report was provided. Notice of site visit was observed being posted and shall remain posted for 30 days.

For any additional questions, call San Bruno CCLD Office, Monday - Friday, 8am - 5pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.

The following forms are to be updated and submitted to CCLD by December 3, 2019:
LIC 500 – Personnel Report

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 11/19/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2019

LIC809 (FAS) - (06/04)

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