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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004062
Report Date: 02/18/2021
Date Signed: 02/18/2021 03:24:42 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:HAPPY CAMPERS INFANT/TODDLER CENTERFACILITY NUMBER:
414004062
ADMINISTRATOR:CARLEIGH SOBERANIS, DIRFACILITY TYPE:
830
ADDRESS:300 EL CAMINO REALTELEPHONE:
(650) 593-2003
CITY:SAN CARLOSSTATE: CAZIP CODE:
94070
CAPACITY:36CENSUS: 17DATE:
02/18/2021
TYPE OF VISIT:Case Management - Licensee InitiatedANNOUNCEDTIME BEGAN:
11:00 AM
MET WITH:Audra TsivikasTIME COMPLETED:
11:35 AM
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On February 18, 2021 at 11:00 AM, Licensing Program Analyst (LPA) Cowan met with licensee Audra Tsivikas for an announced Licensee Initiated Case Management Inspection. Due to Covid-19 State of Emergency, the inspection is conducted via Facetime. Present in the facility is licensee, six staff, and seventeen children. Licensee has requested to designate two rooms (Busy Bees and Butterflies) for 24 toddlers (12 in each room). These two rooms have been approved and use previously for toddlers. Licensee is not changing capacity.

LPA toured Busy Bees and Butterflies rooms. LPA observed rooms are clean and organized. Rooms have age appropriate furniture, toys, and learning materials. Furniture is in good repair. There is a sufficient number of cubbies for toddlers along with napping equipment. Each room has a portable sink with a changing table and garbage can next to it. There is a bathroom for toddler use directly across the hallway with two toilets and two sinks. There is a first aid kit available for both rooms. Rooms are separated by an 8-foot divider made of wood and plexiglass.

The outdoor play area is clean and in good repair with age-appropriate toys. All toys and equipment are in working condition. Children's play area is adequately cushioned with poured rubber to help absorb the impact of falls. Facility has play yard schedule that allows each class to use the yard separately.

On this date, LPA approves rooms for toddlers (Butterflies and Busy Bees).

This report is emailed to licensee with a request for reply demonstrating receipt.
SUPERVISOR'S NAME: Garfield LeungTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: April CowanTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/18/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/18/2021
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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