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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414003092
Report Date: 09/26/2019
Date Signed: 09/26/2019 11:10:13 AM

COMPREHENSIVE INSPECTION
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:CHALLENGE SCHOOL (PS) BELMONT CAMPUSFACILITY NUMBER:
414003092
ADMINISTRATOR:JENNY TSAIFACILITY TYPE:
850
ADDRESS:580 MASONIC WAYTELEPHONE:
(650) 592-6878
CITY:BELMONTSTATE: CAZIP CODE:
94002
CAPACITY:60CENSUS: 31DATE:
09/26/2019
TYPE OF VISIT:Annual/RandomUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Jenny TsaiTIME COMPLETED:
11:20 AM
NARRATIVE
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An Annual Random comprehensive inspection was conducted today. Licensing Program Analysts(LPAs) Glenn Schnell and LPA Wendi Wittmeyer inspected the facility building and grounds, conducted an evaluation of the physical plant, and reviewed children, staff and facility records. A review of staff records during today’s visit indicates that all staff or other individuals who require caregiver background checks have received criminal record and child abuse index clearances or exemptions. Days and hours of operation are: Monday-Friday 8am-6pm

The following was observed today:
Waivers\exceptions on file. This facility has a waiver for electronic sign in and out.
Current facility director/site supervisor is Jenny Tsai
Current designated applicant for the license is Grace Yee and Mei Zhang

The following items were reviewed as part of today's visit: Care and Supervision of the Children, Child Discipline Procedures, Emergency Evacuation Procedures (smoke and carbon monoxide detectors present and in working order), Medication Policies, Isolation of Sick Children will be done in Directors Office until parents pick up, Napping cots were inspected and children bring their own bedding from home, Food Service meals provided by outside vender, staff provides snacks menu was posted, Transportation is not provided, Parents Rights, and Reporting Requirements were observed in children's files reviewed today. Posting requirements. Current forms and Title 22 Regulations can be obtained through the internet at www.ccld.ca.gov. Staff immunization are on file.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
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 2
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: CHALLENGE SCHOOL (PS) BELMONT CAMPUS
FACILITY NUMBER: 414003092
VISIT DATE: 09/26/2019
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 Director was reminded that as of September 1, 2016, a person may not be employed or volunteer of more than 16 hours a week at a child care facility, unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662. Influenza Declarations were also reviewed. Director was advised of the required annual pesticides training. For More information about changes to the Healthy Schools Act, templates, articles, and required training you can inspect the DPR website at: https://apps.cdpr.ca.gov/schoolipm/childcare/training/main.cfm. Director was informed about the Provider Information Notices (PINs) on CCLD website. Director was reminded of Mandated Reporter Training available on CCLD website. Training must be renewed every two years.

Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual – Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm

This facility provides IMS however there is not an IMS plan on file. Director will submit an IMS plan by October 31, 2019. A review of storage of medications, equipment and supplies, and reviewed children, personnel and administrative records.

During the inspection today LPAs received a copy of the :updated Personnel Report (LIC 500) and Emergency Disaster Plan(LIC 610)

No deficiencies cited today.


"NOTICE OF SITE VISIT" DOCUMENT WAS GIVEN TO DIRECTOR AND WILL BE POSTED ADJACENT TO THE MAIN ENTRY DOORWAY AND VISIBLE TO PARENTS.
Notice of site visit must be posted for 30 days.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A SchnellTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 09/26/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 09/26/2019
LIC809 (FAS) - (06/04)
Page: 2 of 2