414003003-2-25-2020-05-CC-MROZ-BM638B-20200225170115

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414003003
Report Date: 02/25/2020
Date Signed: 02/25/2020 05:01:23 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:	PACIFIC RIM INTERNATIONAL SCHOOL (INF)		FACILITY NUMBER:	414003003
ADMINISTRATOR:	CHRISTINIA CHEUNG, EXEC DR		FACILITY TYPE:	830
ADDRESS:	454 PENINSULA AVENUE		TELEPHONE:	(650) 685-1881
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94401
CAPACITY:	12	CENSUS: 9	DATE:	02/25/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	01:00 PM
MET WITH:	Rita Tang		TIME COMPLETED:	05:20 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	Licensing Program Analyst (LPA) Marie Rodriguez conducted an unannounced Annual Required inspection. LPA met with Administrative Director Rita Tang and explained purpose of inspection. The center is a combination center with an infant program and a preschool program with a toddler option. Both programs operate under a separate license. Pacific Rim International School operates under license #414000415. Present in the Nido Room were 3 staff and 9 infants. Center is operating within capacity requirements and in compliance with child to staff ratio. Hours of operation are Monday to Friday from 8:00am to 6:00pm. LPA inspected Nido Room and outdoor play area with Administrative Director. There are no bodies of water, firearms, or weapons on the premises. The center is in good repair with proper temperature and ventilation and is free of any hazards. All furniture is in good condition. Classroom has age appropriate toys and equipment. Room has a separated area designated for napping. Napping equipment includes mats and a crib which are in good condition. Mats are properly stored when not in use. A first aid kit is available in the classroom. All cleaning products and toxins are inaccessible to children. Outdoor play area is fenced for supervision. The outdoor toys and equipment in the play area are age appropriate and in good condition. All required postings and waiver are properly posted in the bulletin board in front of the office. Menu is posted for the whole month. Center provides a hot lunch and a snack. Lunch is cooked in-house by a chef. Kitchen is clean and free of any toxins or contamination. All food is properly stored to avoid contamination. All storage containers for solid waste have a proper lid. Bathroom area has one toilet and one sink for children use with additional potty chairs. Bathroom area appears to be clean, in good repair, and free of any hazards. There is a separate bathroom for staff usage on the premises. There is a changing table and a sink for staff to wash their hands. Changing area is kept clean, in good repair, and maintained with adequate supplies. Changing table is disinfected after every use. (Continued on second page)

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

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: PACIFIC RIM INTERNATIONAL SCHOOL (INF)	FACILITY NUMBER: 414003003
	VISIT DATE: 02/25/2020

NARRATIVE

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(Continued from first page)

Last emergency drill was conducted in January 2020. Emergency drills are conducted monthly and are properly logged. Sign-in/out sheets are done electronically. The center has a complete electronic record of sign-in/out sheets by authorized pickup person. There is a working fire alarm system throughout the center. There is a working smoke and carbon monoxide detector, a fully charged fire extinguisher, and a working telephone available on-site.

Four children records reviewed were complete. All children have a record of emergency identification information on file. Three staff records reviewed were complete. All staff members have a criminal record clearance on file. Staff have a current Pediatric First Aid/CPR certificate which expires January 2021. Incidental Medical Services (IMS) was discussed. Administrative Director stated there are no children who need services this school year.

During inspection,

Administrative Director was given information regarding Safe Sleep Practices, Technical Support Program, Required Lead Testing for Drinking Water in Child Care Centers, and Lead Poisoning Facts Flyer.
Administrative Director was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.622.
Administrative Director was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years by all staff hired. Training can be taken online at www.mandatedreporterca.com. If training is not available in native language, a statement can be written stating exemption until the translation is available and filed in staff record.
Administrative Director was reminded about the Provider Information Notices (PINs) on CCLD website.
Administrative Director was advised for any additional questions to contact CCLD office, Monday to Friday, 8:00am - 5:00pm, (650) 266-8800 or 1 (844) 538-8766. Website: www.cdss.ca.gov.

No deficiencies cited today.

This report was reviewed and discussed with Administrative Director Rita Tang. A copy of report was provided. Notice of site visit was observed being posted and shall remain posted for 30 days.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie Rodriguez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/25/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/25/2020

LIC809 (FAS) - (06/04)

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