414002468-1-27-2020-05-CC-CINO-BL8RTZ-20200127121911

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002468
Report Date: 01/27/2020
Date Signed: 01/27/2020 12:19:20 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:	CHILD DEV CTR-HENRY FORD CHILD DEV. CTR.-PRESCH.		FACILITY NUMBER:	414002468
ADMINISTRATOR:	REYNOLDS, DEANNE P.		FACILITY TYPE:	850
ADDRESS:	2498 MASSACHUSETTS AVENUE		TELEPHONE:	(650) 368-1138
CITY:	REDWOOD CITY	STATE: CA	ZIP CODE:	94061
CAPACITY:	36	CENSUS: 11	DATE:	01/27/2020
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Head Teacher, Alma Salazar		TIME COMPLETED:	12:30 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 Head Teacher, Alma Salazar. Purpose of the inspection as explained. Site Supervisor was at an off-site meeting, and arrived during the inspection. Program operates in Room #B on the Henry Ford Elementary School site. Program operates M-F, 8:30a-11:30a, during the school district calendar. School Age program operates in Room #B and #A in the afternoon (1:20p-6:30p). Present during the inspection was 2 Staff supervising 11 PreK children. Program is in compliance with Staff:Child ratios and all Adults have criminal record clearance. LPA and Head Teacher inspected facility indoors and outdoors for Health and Safety Hazards. Classroom has age appropriate toys and equipment. Cubbies and hooks are used to store children’s belongings. Classroom has 2 restrooms, each with 1 toilet and 1 sink. An additional sink is in the classroom. Restrooms are kept clean, in good repair and maintained with adequate supplies. Staff restrooms are near the main office. Program provides daily snacks. Children do not nap at the facility. Facility has a fully supplied Emergency kit and emergency supplies, which are maintained inaccessible to children. Facility has a functioning telephone, is equipped with an industrial fire alarm system, and smoke and carbon monoxide detectors are installed inside the classroom. Last emergency disaster drill was conducted on 12/05/19 and is properly logged. Discipline policy is mainly redirection. Outdoor play area is free of debris and hazardous items and is completely fenced in. A daily sweep is conducted by staff of the outdoor play area 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 near the main entrance of the classroom. Sign in/out sheet was reviewed and was complete and up-to-date. LPA reviewed Site Supervisor and Staff files, which are complete and up-to-date. 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: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

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: CHILD DEV CTR-HENRY FORD CHILD DEV. CTR.-PRESCH.	FACILITY NUMBER: 414002468
	VISIT DATE: 01/27/2020

NARRATIVE

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Page 2. . .

Also 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: 01/27/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/27/2020

LIC809 (FAS) - (06/04)

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