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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004238
Report Date: 02/22/2022
Date Signed: 02/22/2022 01:29:35 PM


Document Has Been Signed on 02/22/2022 01:29 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: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: 23DATE:
02/22/2022
TYPE OF VISIT:POCUNANNOUNCEDTIME BEGAN:
12:55 PM
MET WITH:Eliana Courtin-LyonTIME COMPLETED:
01:45 PM
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On 2/22/2022 at 12:55P.M, Licensing Program Analyst (LPA) Luis J. Gomez met with Director, Eliana Courtin-Lyon. Purpose of inspection was explained and was an unannounced, plan of correction inspection. Present was director and three staff caring for 23 children. All children present were preschool age and properly signed in. LPA inspected facility with the director for health and safety hazards.

On 2/17/2021, the Department received plan of correction photos from facility via email. During today's inspection, LPA observed and tested facility's Carbon monoxide (CO) detector. Installed detector was in proper functioning order.

Deficiency issued on 2/9/2022, was cleared and ‘Cleared Plan of Correction Letter’ was provided to Director

Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was discussed with Director and signature of this form acknowledges receipt of these documents.

This report must be available in the facility for public review. Notice was provided and must remain posted for 30 days. 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: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 02/22/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 02/22/2022
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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