414002585-5-3-2019-05-CC-GSIH-BBTQR5-20190503122321

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002585
Report Date: 05/03/2019
Date Signed: 05/03/2019 12:23:26 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:	LITTLE BLOOM EARLY CHILD DEVELOPMENT CENTER		FACILITY NUMBER:	414002585
ADMINISTRATOR:	KYRA DE GUZMAN		FACILITY TYPE:	830
ADDRESS:	1911 ELKHORN COURT		TELEPHONE:	(650) 638-9300
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	30	CENSUS: 15	DATE:	05/03/2019
TYPE OF VISIT:	Annual/Random	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Breezy Laurente & Kyra De Guzman		TIME COMPLETED:	10:30 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 Analyst (LPA) Singh met with teacher, Breezy Laurente, for a random annual inspection. Purpose of the inspection was explained. Director, Kyra De Guzman, arrived at the facility during the inspection. Present, there are 15 children with four teachers and the director. Facility is operating with in the capacity and in compliance with staff child ratio on this day. This facility is a combination center. Facility operate day care from Monday to Friday between 7 AM to 6 PM. With teacher, LPA inspected the day care areas: Rooms – Caterpillar, Chenille and Play yard. There are no pools, spas or other bodies of water at the facility. Facility has smoke detector, carbon monoxide detector, fully charged fire extinguisher and working telephone at the site. All of the cleaning solutions, poisons and other chemicals that are dangerous to the children are stored inaccessible to the children. Facility has age appropriate furniture. Furniture is steady and in good repair. Facility has sufficient amount of cribs and sleeping matts. Facility has changing tables with arm reach to the sink. Changing tables are sanitized and in good repair. All storage containers for solid waste and in good repair and have proper lid on top. Facility has refrigerators to store the milk bottles. LPA observed all bottles have child’s name on them. Play yard is free of hazards. All of the play structures are steady, in good repair and free of any loose parts. Any furniture with sharp corners has cushions installed to prevent any injury. There is sufficient amount pads under the play structures to prevent any fall injuries. Per teacher, facility staff brings the water jug with them while the children are in play yard to provide the drinking water. At 10:15 AM, LPA reviewed the facility records. Facility has license, emergency and disaster plan and parent’s rights poster posted and visible for public. There are menus posted at least one week in advance and are visible to the child's authorized representative. LPA reviewed eight random children's and staff's files. See next page for continuation ..............

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

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: LITTLE BLOOM EARLY CHILD DEVELOPMENT CENTER	FACILITY NUMBER: 414002585
	VISIT DATE: 05/03/2019

NARRATIVE

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LPA observed facility has record of names, addresses and telephone numbers of each child's authorized representative. Facility has record of each child’s immunization on file. LPA reviewed the educational qualification of all the teachers. Facility has record of staff immunization on file. LPA observed the completion certificates for completing the mandated reporter training by all staff members. The training can be obtained online at www.mandatedreporterca.com for any new employee.

LPA discussed the safe sleep procedures for the infants. LPA provided the safe sleep regulations concept handout to the director. LPA also discussed the upcoming regulation about checking lead in drinking water at the facility and a handout was provided.

LPA encourages the director to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates. Licensee can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for next 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Gagandeep Singh	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 05/03/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/03/2019

LIC809 (FAS) - (06/04)

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