414004219-1-28-2020-05-CC-BVAN-BL9UP9-20200128144509

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004219
Report Date: 01/28/2020
Date Signed: 01/28/2020 02:46:01 PM

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:	CHAMPIONS - FRANKLIN ELEMENTARY		FACILITY NUMBER:	414004219
ADMINISTRATOR:	TABORA, JOANNE, DIR		FACILITY TYPE:	840
ADDRESS:	2385 TROUSDALE DRIVE		TELEPHONE:	(650) 867-6046
CITY:	BURLINGAME	STATE: CA	ZIP CODE:	94010
CAPACITY:	137	CENSUS: 52	DATE:	01/28/2020
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Megan Pallante		TIME COMPLETED:	03:00 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) Van met with the Director a new Director, Megan Pallante, for an unannounced annual random inspection (Director paperwork had already submitted to licensing). The purpose of the inspection was explained. This facility is a school-aged program. The facility operates in the Franklin Elementary School in Burlingame, the rooms utilized are #10, #19, and #20 and two portable rooms #23 and #24. Days and hours of AM program operations are: Monday - Friday 7:00 am-8:45 am, and PM program is 2:00 pm - 6:00 pm. During recess periods and summer, the operations hours are Monday – Friday 7 am – 6 pm. Present, there are 52 children, 5 teachers and 3 aides. LPA, along with the Director, inspected the facility for health and safety hazards. A variety of age-appropriate toys and learning materials for children are available in the classroom. There are no pools, spas, or other bodies of water at the facility. The facility has a centralized smoke detector and a fully charged fire extinguishers. All cleaning solutions, poisons, and other dangerous chemicals were locked and stored inaccessible to children. Sick children will be separated from the group and will be waiting in the staff area of the room for parents to pick up. The facility is in good repair and free of any hazards with proper temperature and ventilation. The children's bathrooms are located outside of the classrooms, and staff will escort the children to the bathrooms. Drinking water is readily available for children indoor and outdoor. The facility serves afternoon snacks. The outdoor playground area is in good repair, and play structures are free of any loose parts. In today’s inspection, LPA reviewed random samples of staff and children's records. LPA observed that the facility has a sign-in / out record for the parent or authorized representative. All children had a medical assessment, and required licensing forms were completed. All staffs have criminal record clearance, a record of valid

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

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: CHAMPIONS - FRANKLIN ELEMENTARY	FACILITY NUMBER: 414004219
	VISIT DATE: 01/28/2020

NARRATIVE

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Pediatric FirstAid/CPR card in the file, and the required immunization. And all staffs have verification of the mandated child abuse reporting training as compliant with AB1207. LPA also observed that the facility had posted the required forms. (i.e., License, waivers, Notification of Parent's Rights, and Notification of Personal Right). The Director stated that Fire and Earthquake drills are done each month and or when the school conducts the drill for the entire school.

LPA reminded the lead teacher that as of September 1, 2016. A person may not be employed or volunteer at a childcare facility unless he or she has been immunized against influenza, pertussis, and measles. LPA observed the facility has a record of required immunization of all staff.

LPA reviewed AB 1207 with the lead teacher. As of January 1, 2018, all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

ADA information was provided; US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to the publication.

Pesticides training was also discussed (Information on the DPR website at www.cdpr.ca.gov/shoolipm/childcare),

LPA also went over the Child Care Center checklist and provided a copy to the Director during the inspection

No deficiencies are cited today. The copy of this report is reviewed and provided to the director. Notice of site visit is posted and shall remain posted for the next 30 days.

SUPERVISOR'S NAME: Garfield Leung	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Brendon Van	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 01/28/2020

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 01/28/2020

LIC809 (FAS) - (06/04)

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