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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004208
Report Date: 05/26/2022
Date Signed: 05/26/2022 02:59:43 PM


Document Has Been Signed on 05/26/2022 02:59 PM - It Cannot Be Edited

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:IMAGINATION STATION (INF)FACILITY NUMBER:
414004208
ADMINISTRATOR:AGUIRRE, RAELIFACILITY TYPE:
830
ADDRESS:280 - 92ND STREETTELEPHONE:
(650) 746-8356
CITY:DALY CITYSTATE: CAZIP CODE:
94015
CAPACITY:11CENSUS: 9DATE:
05/26/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
12:00 PM
MET WITH:Raeli AguirreTIME COMPLETED:
03:30 PM
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On May 26, 2022, Licensing Program Analyst (LPA) Kaur met with Director Raeli Aguirre for an unannounced annual random inspection. Present today are 9 infants supervised by 2 teachers. The facility complies with the Staff-Infant ratios today. This program operates year-round. Current operations hours are Monday – Friday 7:30AM to 6:00 PM. The program has 2 room for infants. The isolation area for an ill child is in the front desk room, and the staff will monitor and supervise the child while parents are contacted to come and pick up.

Along with the Director, LPA inspected the Center for health and safety hazards. LPA observed that the facility has electronic sign-in / out app for parents or authorized representatives. The Center is clean and orderly. Heating, lighting, and ventilation are adequate. The facility is furnished with age-appropriate toys, furniture, cribs, changing tables, and equipment. LPA observed no pools, spas, or other bodies of water or any walkers, bouncers, or other similar items in the Center. Per the Director, there are no firearms or weapons at the Center. All cleaning supplies or other potentially harmful items are stored inaccessible to the children. Separate staff bathrooms are available. All solid waste storage containers have tight-fitting lids. The facility has more than one carbon monoxide detector, a centralized smoke alarm, and a fully stocked First Aid kit.

The outdoor infant play area is kept free of debris and dangerous conditions. All outdoor toys and equipment are age-appropriate and in good repair. Drinking water is readily available indoors and outdoors.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/26/2022
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: IMAGINATION STATION (INF)
FACILITY NUMBER: 414004208
VISIT DATE: 05/26/2022
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There are cubbies available for children's belongings with names labeled. LPA observed changing area with 1 hand washing sink. LPA observed that the diaper changing tables have at least 1" thick padding with sides raised to a minimum of 3". The changing tables are within arm's reach of disposable wipes are used to clean after each use. There is a separate napping area for children to nap or rest without distraction or disturbance. There is enough sleeping equipment, cribs, and cots for each child. Per Director, the staff is always present in a designated area visually observes children in the napping room. Mats and beddings are appropriately stored. Breast milk/formula parents provide is stored appropriately in the refrigerator, and each bottle is labeled. Parents provide formula, food, and diapers for their children. LPA observed that the food prep area was clean and organized. The infant bottles are returned to the parents daily for washing.
LPA reviewed personnel's' and children's records. Children's files were reviewed and found to have medical assessments, needs, services, feeding plans, and signed admission agreements. Staff files are organized, complete, and have documentation of education credits. Multiple staff members have valid CPR cards in files and have immunization documentation for Measles, Pertussis, and Influenza. LPA also observed that the facility had posted the required forms. (i.e., License, menus, waivers, Notification of Parent's Rights, Notification of Personal Rights, Car Seat Law, and Emergency Disaster Plan). The Director stated Fire and Earthquake drills are done quarterly, and the last fire drill was conducted on May 5, 2022.
The Director was reminded that all adults 18 and over, including employees and volunteers, must obtain a criminal record clearance or exemption or transfer their existing clearance or exemption prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.
LPA discussed the safe sleep regulations with the Director and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed the Director of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022
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: IMAGINATION STATION (INF)
FACILITY NUMBER: 414004208
VISIT DATE: 05/26/2022
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Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manuel – Regulations Interpretations and Procedures for Child Care Centers Section 101173 and 101226. When an IMS is provided, an updated Plan of Operations that includes IMS must be submitted to the Department. Following information regarding ADA was provided: US Department of Justice (USDOJ) toll- free ADA information line at (800) 514- 0382 (TTY) and link to publications: Commonly asked questions about Child Care Centers and the ADA, available at: http://www.ada.gov/childqanda.htm
The Director was informed about Mandated Reporter training available on the CCLD website. In addition to AB1207 training required to complete every two years by the Licensee and all staff hired, a one-time General Training is also required. Training can be taken online at www.mandaterreporterca.com. Also, the Director was reminded of Pesticides training. Information on the DPR website at: www.cdpr.ca.gov/shoolipm/childcare
LPA encouraged the Director to frequently visit the Licensing website at www.ccld.ca.gov for licensing regulations and new updates. Director can also email at childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.
. To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/process.
No deficiencies were cited today. An exit interview was conducted, and the report was reviewed with the Director, Raeli Aguirre. Today's report, May 26, 2022, and notice of site visit will be sent to the Director by email BKIMAGINATIONSTATION@GMAIL.COM by the close of business on May 26, 2022. Confirmation of receipt is required. LPA informed the Director that the site visit notice must be posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.
Facility was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Ali ZebilaTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran KaurTELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/26/2022
LIC809 (FAS) - (06/04)
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