414002676-6-29-2023-05-CC-CQUO-CT9T7G-20230629142842

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002676
Report Date: 06/29/2023
Date Signed: 06/29/2023 02:28:45 PM

Document Has Been Signed on 06/29/2023 02:28 PM - It Cannot Be Edited

STATE OF CALIFORNIA - HEALTH AND HUMAN SERVICES AGENCY

FACILITY EVALUATION REPORT

CALIFORNIA DEPARTMENT OF SOCIAL SERVICES
COMMUNITY CARE LICENSING DIVISION
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PENINSULA JEWISH COMMUNITY CENTER (SA)		FACILITY NUMBER:	414002676
ADMINISTRATOR:	LEVIN, STEPHANIE		FACILITY TYPE:	840
ADDRESS:	800 FOSTER CITY BLVD		TELEPHONE:	(650) 378-2762
CITY:	FOSTER CITY	STATE: CA	ZIP CODE:	94404
CAPACITY:	120	CENSUS: 0	DATE:	06/29/2023
TYPE OF VISIT:	Case Management - Licensee Initiated	UNANNOUNCED	TIME BEGAN:	08:30 AM
MET WITH:	Nicole Francis, Lauren Ngoi, Kirsten Hove & Renee Keller		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	On June 29, 2023 at approximately 8:30am, Licensing Program Analyst (LPA) Catrina Quimbo conducted a case management inspection at Peninsula Jewish Community Center. LPA met with director, Nicole Francis, associate director, Lauren Ngoi, and explained the purpose of the inspection. Also present during visit included consultant, Kirsten Hove, and operations manager, Renee Keller. Program is an already licensed combination program for preschool and school age children. School age program is licensed for 120 school age children. Facility is requesting to increase the school age capacity to 144 school age children (TK to 5th grade) and addition of Classroom #13. Fire clearance was received for the capacity of 144 school age children 06/27/2023. The facility is located at Peninsula Jewish Community Center. Main entrance to program will be through side gate located on South Road. During LPA's visit, summer camp program was in session. The facility will continue to operate Monday through Friday from 1:00pm to 6:00pm. School age program is licensed to operate in Tree House A, B, C and Preschool classroom #14 and #15. Classroom #13 is an already licensed Preschool classroom. Preschool children enrolled in Classroom #13 are part time children that are present from 8:30am to 1:00pm. School age children will operate in Classroom #13 in the afternoon from 1:00p to 6:00pm. LPA discussed preschool children and school age children are not to co-mingle and are to be kept separate. The classroom was inspected for health and safety hazards. Summer camp program is currently utilizing classroom #13 during LPA's visit. The school age program is exempt from requirements for indoor and outdoor space square footage, fencing, and toilet/sink ratios. No measurements were taken during the inspection. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

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
SAN BRUNO CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PENINSULA JEWISH COMMUNITY CENTER (SA)	FACILITY NUMBER: 414002676
	VISIT DATE: 06/29/2023

NARRATIVE

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LPA observed classroom to be equipped with age appropriate toys, materials and furniture. Classroom is appropriately ventilated with proper temperature. All poisons, cleaning solutions and hazardous materials are stored inaccessible behind child safety locked cabinets. Classroom is equipped with emergency backpacks that contain first aid and emergency materials. Classroom is also equipped with fire alarm system that contains fire sprinklers and a fully charged fire extinguisher. Per director, carbon monoxide detector is implemented in smoke alarm system.

There is a restroom inside the classroom that was observed to be in proper working condition. Restroom allows for individual privacy for school age children. LPA observed garbage bins in classroom and restroom to have a tight fitting lid.

The entire outdoor area is fully enclosed and separate from preschool program. Outdoor area includes a field with artificial turf and black tops. LPA observed outdoor toys and materials to be properly stored and maintained. There is an additional, accessible restroom in outdoor area that allows for individual privacy. Bathrooms were observed to be in proper working condition. Water is made available to children indoors and outdoors, by water fountains and children's individual water bottles that can be refilled on site.

Associate director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

After today's visit, LPA will approve capacity increase for 144 school age children and operating in classroom #13.

Exit interview conducted and report was reviewed with associate director, Lauren Ngoi.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 06/29/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/29/2023

LIC809 (FAS) - (06/04)

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