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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004238
Report Date: 02/09/2022
Date Signed: 02/09/2022 01:22:00 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:PLAYGROUPS UNLIMITED - UNIVERSE OF COLORSFACILITY NUMBER:
414004238
ADMINISTRATOR:COURTIN-LYON, ELIANAFACILITY TYPE:
850
ADDRESS:178 SOUTH BOULEVARDTELEPHONE:
(650) 401-8368
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:30CENSUS: 24DATE:
02/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
08:45 AM
MET WITH:Eliana Courtin- LyonTIME COMPLETED:
01:30 PM
NARRATIVE
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On 2/9/2022 at 8:45A.M., Licensing Program Analyst (LPA), Luis J. Gomez met with Director, Eliana Coutin-Lyon. Purpose of the inspection was explained and was for an unannounced, annual inspection. Present was the Director and three staff supervising 24 children. All children present were preschool age and had been properly signed in. All staff had their criminal record clearances on file with the Department. Program utilizes three classrooms: #1, #2, #3, Lunch/ Snack room and one Outdoor Play Area. Hours of operation are: Monday- Friday 8:00am- 6:00pm. Program operates year-round. Facility was inspected, indoors and outdoors, with director for health and safety hazards.

At 9:10A.M., LPA observed the following: Classrooms were clean and orderly and had a variety of age-appropriate books, blocks and supplies for the children. Floors and ground surfaces were free of obstructions. Facility was equipped with labelled cubbies for storage of children's belongings. All accessible furniture and playthings were in good repair. Each classroom had several child sized, desks, tables and chairs. Children's bathroom was inspected, with all fixtures were in operating condition. (2 toilets, 3 sinks) Bathrooms had adequate supplies for the children, and diaper changing table. Per director, table is cleaned after each use. Staff bathroom is located in facility hallway. For napping services, program provides cleanable cots, assigned to each child. LPA observed napping supplies are stored in individual cubbies. Per director, children's napping supplies cleaned daily and blanks are washed weekly. Classroom had acceptable ventilation and lighting. Cleaning detergents, supplies, spray bottles and all other toxins were made inaccessible, stored in the off-limits areas. Outlets had been properly covered. LPA reminded director to ensure all accessible trash bins have tight fitting lids. Facility has a functioning smoke detector and two fully charged fire extinguishers (3A:40BC) located in each classroom.

At 9:50A.M., Based on observations and interviews, LPA confirmed facility does not have functioning carbon monoxide (CO) detector.

First aid kit and emergency disaster supplies were reviewed during inspection.

(REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
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 5
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: PLAYGROUPS UNLIMITED - UNIVERSE OF COLORS
FACILITY NUMBER: 414004238
DEFICIENCY INFORMATION FOR THIS PAGE:
VISIT DATE: 02/09/2022

DEFICIENCIES & PLANS OF CORRECTION (POCs)
Type B
Section Cited
HSC
1596.954
Licensure Requirements
Every licensed child day care center shall have one or more carbon monoxide detectors in the facility that meet the standards established in Chapter 8 (commencing with Section 13260) of Part 2 of Division 12. The department shall account for the presence of these detectors during inspections.

This requirement is not met as evidenced by:
Deficient Practice Statement
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At 9:50A.M., Based on observations and interviews, LPA confirmed facility does not have functioning carbon monoxide (CO) detector. This poses a potential health and safety risk to children in care.
POC Due Date: 02/18/2022
Plan of Correction
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Director will obtain and install functioning carbon monoxide detector by the due date: 2/18/2022. Director will submit proof of correction to the Department via email.
Section Cited
Deficient Practice Statement
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POC Due Date:
Plan of Correction
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Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/09/2022
I acknowledge receipt of this form and understand my appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/09/2022
LIC809 (FAS) - (06/04)
Page: 2 of 5
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: PLAYGROUPS UNLIMITED - UNIVERSE OF COLORS
FACILITY NUMBER: 414004238
VISIT DATE: 02/09/2022
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(Page 2)

At 9:55A.M., LPA inspected outdoor play area. Area was completely enclosed with tall fencing, and free of any debris or hazardous items. Playthings inspected where is good repair. Per director, water service is provided for children using refillable water bottles.

At 10:00A.M. Based on observation, LPA confirmed awning for the outdoor shaded rest area, was missing from structure. During inspection, Advisor Note: Technical Assistance (LIC9102) was issued to facility.

At 10:15A.M., LPA review the facility records including: 10 children’s files and all personnel files. Children's files reviewed were complete and included: Health History (LIC702), Identification of Emergency Information, Consent for Medication Treatment, Parent’s Rights and Immunization Records.

Staff files were reviewed and included: Criminal Record Statements (LIC508), Immunization Record, Declaration to Report Suspected Child Abuse (LIC9108), Transcripts and Notice of Employee Rights (LIC9052). All staff's current mandated reporter training certifications were on file.

Staff’s had a current CPR/ 1st aid certification, which will expire: 1/2023. Emergency drills are conducted at the facility, with the last drill done on 11/15/2021, properly logged. Per director, families provide all daily snacks and meals for children in care. LPA reminded director to ensure any container brought from home are properly labelled with child’s name. Facility's refrigerator was reviewed during inspected, and was observed to be in working order.

All required posting had been posted, included facility’s License, Notification of Parents Rights (PUB393) and Emergency Disaster Plan (LIC610). During inspection, LPA reviewed children’s medication. Medications items reviewed were current and properly stored.

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 Child Care Center. A civil penalty of $100.00 minimum/ day up to $500.00 maximum per day/per person will be assessment if this regulation is violated.

(REFER TO 809C, FOR CONT.)

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
LIC809 (FAS) - (06/04)
Page: 4 of 5
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: PLAYGROUPS UNLIMITED - UNIVERSE OF COLORS
FACILITY NUMBER: 414004238
VISIT DATE: 02/09/2022
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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

Based on today's inspection, deficiencies were observed in areas evaluated, according the Title 22 Division 12 Ca. Code of Regulations and cited on the 809D. Exit interview and plan of correction was discussed with director, Eliana Courtin-Lyon and her signature of this form acknowledges receipt of these documents.



Notice was provided and must remain posted for 30 days.

This report and rights to comment were discussed. This report must be available in the facility for public review. For additional questions, facility was advised to contact the Community Care Licensing Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 02/09/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/09/2022
LIC809 (FAS) - (06/04)
Page: 5 of 5