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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002475
Report Date: 06/21/2021
Date Signed: 06/21/2021 11:23:34 AM

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:COASTSIDE CHILDREN'S PROGRAMS - MONTARAFACILITY NUMBER:
414002475
ADMINISTRATOR:MARY BRISEBOISFACILITY TYPE:
850
ADDRESS:1100 LE CONTE AVENUETELEPHONE:
(650) 728-0174
CITY:MONTARASTATE: CAZIP CODE:
94037
CAPACITY:40CENSUS: 9DATE:
06/21/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
09:45 AM
MET WITH:Mei ClarkTIME COMPLETED:
11:30 AM
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Licensing Program Analyst (LPA) Van met with the Executive Director, Mei Clark, for a case management inspection. The purpose of today's visit is to review and discuss the temporary plans for the Coastside Children Pre-School Program in building #2 to use the Coastside Children School-age Program's classroom in building #3. The Preschool program building is under emergency construction due to a roofing issue. The Executive Director estimated it would take approximately two weeks to complete the repair. Currently, the school-age program is out on summer recess and will resume on 8/12/21. The Executive Director, therefore, wishes to use a School-age classroom for the Preschool program temporarily. The School-age program is licensed for 42 children, and the PreSchool program is licensed for 40. However, the number of Preschool children currently enrolled in the Preschool program is only 9.

Fire Safety Inspection request was sent to the Half Moon Bay Coastside Fire Department on 5/13/21 and was approved as of 6/2/21.

During today's inspection, LPA inspected the School-age classroom where children from the Preschool program will be utilized. The classroom is clean and orderly. Heating, lighting & ventilation are adequate. The School-age classroom has a bathroom with 2 sinks, 2 toilets, and a separate staff bathroom. The furniture and equipment are in good repair and are free from loose sharp, or pointed parts. The classroom has a carbon monoxide detector, and smoke alarm installed. In addition, classrooms are equipped with fully supplied First Aid. There are fences encloses the playground to protect children and keep them in the outdoor activity area.

The facility will be approved for temporary use of the School-age classroom for the Preschool program today, 6/21/21.

The report was reviewed and signed by the Executive Director, Mei Clark. Today's report, 6/21/2021, and notice of site visit will be sent to the Executive Director at mei@coastsidechildren.org by close of business on 6/21/21. Confirmation of receipt is required.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon VanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 06/21/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/21/2021
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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