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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414002941
Report Date: 03/11/2020
Date Signed: 03/11/2020 03:56:32 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:ODYSSEY PRESCHOOLFACILITY NUMBER:
414002941
ADMINISTRATOR:ANNE DIAMOND, DIRECTORFACILITY TYPE:
850
ADDRESS:1151 E HILLSDALE BLVD.TELEPHONE:
(650) 525-1727
CITY:FOSTER CITYSTATE: CAZIP CODE:
94404
CAPACITY:142CENSUS: 103DATE:
03/11/2020
TYPE OF VISIT:Case Management - IncidentUNANNOUNCEDTIME BEGAN:
02:30 PM
MET WITH:Director, Anne DiamondTIME COMPLETED:
04:10 PM
NARRATIVE
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On March 11th,2020 at 2;30 PM, Licensing Program Analyst (LPA) Kassandra Medrano met with Director, Anne Diamond for an unannounced Case Management Inspection. The purpose of the inspection was to discuss an unusual incident that occurred on February 11, 2020; which was reported to the department by the center.

On the day mentioned above, Facility has an incident occur that the facility can neither prove or disprove. At 2:49, LPA asked director stated person had just been hired 3/9/2020 therefore hadn't been fingerprinted. Therefore facility has an uncleared individual on premises. Individual was immediately removed and can not return until clearance is granted. Civil penalty to be assessed.

Based on information available, as well as observations made the incident resulted in lack of supervision.

A Type “A” violation was issued today. The center was advised to provide a copy of the Evaluation Report and the Type “A” Deficiency cited to the parents and guardians of children currently enrolled in care and to parents of newly enrolled children during the next 12 months. A signed and dated LIC 9224 shall be maintained in all Children's files. This report and appeal rights were provided and reviewed with the Site Director. Notice of Site Visit and Type A Citation shall remain posted for 30 days.

SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 03/11/2020
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/11/2020
This report must be available at Child Care and Group Home facilities for public review for 3 years.
LIC809 (FAS) - (06/04)
Page: 1 of 3
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: ODYSSEY PRESCHOOL
FACILITY NUMBER: 414002941
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type A
03/12/2020
Section Cited

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101170 Criminal Record Clearance
(a) The Department shall conduct a criminal record review of all persons specified in Health and Safety Code Section 1596.871(b). The Department has the authority to approve or deny a facility license, or employment, residence or presence in the facility, based on the results of this review.
This requirement was not met as evidenced by:
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Based on record review and interview with director and individual she was hired 3/9/2020 and has yet for complete fingerprints. This poses an immediate health and safety risk to children.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2020
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: ODYSSEY PRESCHOOL
FACILITY NUMBER: 414002941
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 03/11/2020
Deficiency Type
POC Due Date /
Section Number
DEFICIENCIES
PLAN OF CORRECTIONS(POCs)
Type B
04/08/2020
Section Cited

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101229(a)(1) Responsibility for Providing Care and Supervision
(a) The licensee shall provide care and supervision as necessary to meet the children's needs.(1) No child(ren) shall be left without the supervision of a teacher at any time, except as specified in Sections 101216.2(e)(1) and 101230(c)(1). Supervision shall include visual observation. This requirement was not met as evidenced by:
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Based on interviews with s1 and director, as well as visual observations made by LPA. Incident resulted in lack of supervision. This poses a potential health and safety risk to children.
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Kassandra MedranoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 03/11/2020
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 03/11/2020
LIC809 (FAS) - (06/04)
Page: 3 of 3