414002820-12-6-2022-05-CC-LGOZ-CLUSAY-20221206124306

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414002820
Report Date: 12/06/2022
Date Signed: 12/06/2022 12:43:19 PM

Document Has Been Signed on 12/06/2022 12:43 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
CCLD Regional Office, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	HIGHLANDS RECREATION DIST. (INFANT)		FACILITY NUMBER:	414002820
ADMINISTRATOR:	LEIN, KRISTEN		FACILITY TYPE:	830
ADDRESS:	1851 LEXINGTON AVENUE		TELEPHONE:	(650) 341-4251
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY:	8	CENSUS: 8	DATE:	12/06/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:20 AM
MET WITH:	Kristen Lein		TIME COMPLETED:	12:55 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 12/6/2022 at 9:20AM., Licensing Program Analyst, Luis J. Gomez met with Director, Kristen Lein. Purpose of the inspection was explained and was for an Unannounced, Annual/ Random inspection. Facility is a Combination Center with Preschool program on-site. Present was the director and three staff supervising 8 children. Children present have been signed-in by authorized representatives. Staff have criminal record clearances are on file. Infant program utilizes one classroom and one outdoor play space. Hours of operation are Monday- Friday 7:30am- 6:00pm. Program operates year-round. LPA inspected facility, indoors and outdoors, for health and safety hazards. At 9:30AM., LPA observed the following: Infant classrooms was clean, orderly, with age-appropriate toy and playthings available for the children. Ground surfaces were free of hazards or potential obstructions. Infant classroom is separated into activity areas which include: Recreation, Feeding and Napping Room. Area has child size table and chairs with moist resistant material. Furnishings inspected were free of sharp points or corners. Classroom entry way had individual storage cubbies. Classrooms were equipped with diaper changing table (within arm’s reach of a sink). Per director, changing table is disinfected after use, and trash bins are emptied daily. Food preparation area is located separately and equipped with refrigerator and sink. Milk and food items inspected have been properly stored and labeled. For napping services, each infant had their own designated crib. Cribs are equipped with tight-fitting sheets, and proper sized mattresses. Infant crib’s design allows for constant staff supervision. Per director, napping linins are changed daily, with full sets (5 pieces) washed weekly. (REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

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: HIGHLANDS RECREATION DIST. (INFANT)	FACILITY NUMBER: 414002820
	VISIT DATE: 12/06/2022

NARRATIVE

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Classroom has acceptable ventilation and lighting. Trash bins and outlets have been properly covered. LPA observed accessible children's sink was in operating condition with adequate supplies. Staff restroom is located in facility hallway. Detergents; cleaning supplies; compounds and sharp objects were inaccessible. Classroom had carbon monoxide and smoke detector (built into building), pull alarm, and a charged fire extinguisher (3A40:BC).

At 10:00AM., LPA inspected the outdoor play area. LPA observed area was completely enclosed with shaded resting area available. Area was clear of debris or other hazardous items. Play items and sensory stations were in like-new condition. Per director, water services are provide with water pitcher and children’s cups. LPA reminded director to ensure water is available at all time.

10:20AM., LPA reviewed the facility and children records. Record review included 8 children’s files and three personnel files. Personnel record included: ‘Mandated Reporter Training’ certification (AB1207); Notice of Employee Rights (LIC9052); Declaration to Report Suspected Child Abuse (LIC9108); Teacher Qualification; and Criminal Record Statement (LIC508).

LPA reminded director to ensure staff’s required immunization records are stored in facility files. Advisory Note: Technical Violation (LIC9102TV) was issued.

Director had their current Cardiopulmonary Resuscitation/ First Aid Certification on file, which expires: 12/2022.

Children files were reviewed, and included: Infant Needs and Services Plan; Identification of Emergency Information (LIC700); Immunization Records; Napping Logs; Individual Infant Sleeping Plan (LIC9227); Physician's Report (LIC701); and Admissions Agreement.
(REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

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: HIGHLANDS RECREATION DIST. (INFANT)	FACILITY NUMBER: 414002820
	VISIT DATE: 12/06/2022

NARRATIVE

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Per director, emergency drills are being conducted every six months, with last drill done: 11/9/2022.

Required posting were observed in facility hallway. Posting are properly posted in facility and include the childcare license; Notification of Parent’s Rights; Emergency Disaster Plan; and Passenger Safety Laws.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

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 Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

LPA discussed safe sleep regulations with the director and discussed Child Care Licensing Safe Sleep webpage at: http://www.cdss.ca.gov/inforesource/child-care-licensing/public-information-and-resouce/safe-sleep as an additional resource. LPA also informed director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at: http://www.cpsc.gov/ and recommend they register all infant devices with the CPSC to be notified of any recalls on their purchased requirement.
Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview and report was reviewed with Director, Kristen Lein, and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. Facility 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: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/06/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/06/2022

LIC809 (FAS) - (06/04)

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