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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414003012
Report Date: 08/03/2021
Date Signed: 08/03/2021 03:00:33 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:ST. MATTHEWS EPISCOPAL DAY SCHOOLFACILITY NUMBER:
414003012
ADMINISTRATOR:HUDEC, ERINFACILITY TYPE:
850
ADDRESS:15 2ND AVENUETELEPHONE:
(650) 342-5436
CITY:SAN MATEOSTATE: CAZIP CODE:
94401
CAPACITY:20CENSUS: 0DATE:
08/03/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
01:00 PM
MET WITH:Erin HudecTIME COMPLETED:
03:15 PM
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Licensing Program Analyst (LPA) Marie Rodriguez met with Site Director Erin Hudec for an announced case management inspection. On July 20, 2021, Site Director submitted an application to CCLD for a capacity increase of 34 and the room addition of Classroom #2 for a second preschool class. Facility is currently closed for summer break and will reopen on August 24, 2021 for the fall semester. No day care children were present at time of inspection.

LPA and Site Director inspected Classroom #2 for Health and Safety hazards. Classroom #2 has age appropriate toys and equipment available for children in care.

Based on previous measurements for Classroom #1 (current room) and Classroom #2 (room addition), total indoor space for both classrooms equals 1,305.19 sq ft, with an available indoor capacity of 37 children. Outdoor space has a total of 4,477.80 sq ft, with an available outdoor capacity of 59 children. Current fire clearance capacity on file includes Classroom #2.

Capacity increase to 34 children and room addition of Classroom #2 has been granted.

No deficiencies cited today.

Report was reviewed and discussed with Site Director Erin Hudec. A copy of report was provided.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Marie RodriguezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/03/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/03/2021
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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