414002020-5-8-2019-05-CC-CINO-BBYVDV-20190508162123

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002020
Report Date: 05/08/2019
Date Signed: 05/08/2019 04:21:35 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:	CITY OF MENLO PARK-MENLO CHILDREN'S CTR-PRESCHOOL		FACILITY NUMBER:	414002020
ADMINISTRATOR:	BONHAM, NATALIE		FACILITY TYPE:	850
ADDRESS:	801 LAUREL ST., RM 104 & 108		TELEPHONE:	(650) 330-2260
CITY:	MENLO PARK	STATE: CA	ZIP CODE:	94025
CAPACITY:	72	CENSUS: 52	DATE:	05/08/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	01:05 PM
MET WITH:	Senior Program Assistant, Da'Shawn Williams and Recreations Supervisor, Natalia Jones		TIME COMPLETED:	03:00 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), Cindy Interiano, conducted an Annual/Random inspection this day and met with Senior Program Assistant, Da'Shawn Williams and Recreations Supervisor, Natalia Jones. Purpose of the inspection was explained. Facility operates Mon-Fri, 8a-6p, year-round with periodic breaks. Program operates in three classrooms: Toddler Room, Early PreK Room, PreK room which is divided into two classrooms: PreK and ‘Morning Birds.’ ‘Morning Birds’ class operates 8:30a-12p, following the School District Calendar. LPA, Senior Program Assistant, and Recreations Supervisor inspected the facility indoors and outdoors for Health and Safety hazards. Present during the inspection is Senior Program Assistant and Recreations Supervisor and 9 Staff supervising 52 children: 12 Toddlers and 40 PreK children. Facility is in compliance with Staff:Child ratios. Classrooms have age appropriate toys and equipment, maintained in good condition. Cubbies and hooks inside each classroom are used to store children’s belongings. Napping equipment is properly stored. Classrooms have proper ventilation and sufficient lighting. Classrooms each have a children’s restroom which have 2-4 toilets and 2-4 sinks, and some with a changing table. An additional sink is in each classroom. Restrooms are kept clean, in good repair, and maintained with adequate supplies. There are separate staff restrooms, which are maintained off limits to children. Children bring their own meals or can purchase a meal for a fee through Program's food vendor: ‘Kidango.’ Program provides daily snacks. Facility has a fully supplied Emergency Kit and Emergency supplies, which are maintained inaccessible to children. Facility is equipped with an industrial fire alarm system, a carbon monoxide detector, and a Fire Extinguisher. All cleaning products and toxins are stored inaccessible to children. There are no bodies of water, firearms or other dangerous weapons on the premises. Last Emergency Disaster drill was conducted on 01/31/19 and is properly logged. 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: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

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: CITY OF MENLO PARK-MENLO CHILDREN'S CTR-PRESCHOOL	FACILITY NUMBER: 414002020
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 05/08/2019

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 05/22/2019 Section Cited CCR 101229.1(a)(1)	1 2 3 4 5 6 7	101229.1(a)(1) The person who signs the child in/out shall use his/her full legal signature and shall record the time of day. LPA reviewed sign in/out logs for the Toddler classroom: present were	1 2 3 4 5 6 7	Facility will send copy of 'Parent Newsletter' to CCLD by due date and will include sign in/out procedure. A follow-up inspection may be required.
	8 9 10 11 12 13 14	12 Toddlers, however 11 were signed in. This requirement was not met as evidence based on review of sign in/out logs. This poses a Potential safety risk to children in care.	8 9 10 11 12 13 14
	1 2 3 4 5 6 7		1 2 3 4 5 6 7
	1 2 3 4 5 6 7		1 2 3 4 5 6 7

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

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

Page: 3 of 3

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: CITY OF MENLO PARK-MENLO CHILDREN'S CTR-PRESCHOOL	FACILITY NUMBER: 414002020
	VISIT DATE: 05/08/2019

NARRATIVE

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Page 2. . .
Outdoor play area consists of 3 fenced areas: ‘Toddler’s yard,’ ‘Playground A,’ and ‘Playground B.’ Outdoor play area is maintained free of debris and dangerous conditions. A daily sweep of the outdoor play area is conducted by staff prior to children going out for outdoor play. Outdoor playarea is completely fenced in. Sandbox is covered daily and inspected throughout the day. All outdoor toys and equipment are age appropriate and in good repair. Drinking water is readily available indoors and outdoors. Last emergency drill was conducted on 01/31/19 and is properly logged. All required postings, including bathroom and outdoor play waivers, are properly posted near the main entrance of the facility. LPA reviewed sign in/out sheets. All staff have required immunization and Mandated Reporter training certificate on file.

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

Facility was provided with an updated License allowing for a capacity of 72 children: 12 Toddlers (ages 18-36 months) and 60 PreK children (ages 2-6 years old).

***See following page for deficiencies cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

>This report and rights to comment and appeal were discussed with Senior Program Assistant and Recreations Supervisor. 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, 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: 05/08/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/08/2019

LIC809 (FAS) - (06/04)

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