414004238-2-14-2023-05-CC-LGOZ-CP2RKZ-20230214120623

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004238
Report Date: 02/14/2023
Date Signed: 02/14/2023 12:06:38 PM

Document Has Been Signed on 02/14/2023 12:06 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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME:	PLAYGROUPS UNLIMITED - UNIVERSE OF COLORS		FACILITY NUMBER:	414004238
ADMINISTRATOR:	COURTIN-LYON, ELIANA		FACILITY TYPE:	850
ADDRESS:	178 SOUTH BOULEVARD		TELEPHONE:	(650) 401-8368
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94402
CAPACITY:	30	CENSUS: 26	DATE:	02/14/2023
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Eliana Coutin Lyon		TIME COMPLETED:	12:15 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

On 2/14/2023 at 8:50AM., Licensing Program Analyst (LPA), Luis J. Gomez met with Director, Eliana Courtin-Lyon. Purpose of the inspection was explained and was for an unannounced; Annual/ Random inspection. Facility is licensed to operates preschool program. Present was the directors and five staff supervising 26 children. Children present have been properly signed in. Staff present have criminal record clearances on file. Program operates in three classrooms: #1, #2, #3, Snack/ Lunch Area, and one, shared outdoor play yard. Days and 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 9:00AM., LPA observed the following: Classrooms were clean and orderly, with age-appropriate plaything and materials available to the children. Floors and ground surfaces were free of obstructions. Storage hangers are located hallway for child’s belongings. Supplies, furniture and books inspected were in good repair and free of sharp corners or splinters. Each classrooms has child sized tables and chairs. Children’s bathrooms located snack/ lunch area have adequate supplies for hand washing. Fixtures in children's bathrooms were in operating condition. LPA reminded director to ensure visual supervision is provided at all times. Diaper changing table is available. per director, changing table is disinfected after each use. Staff bathroom is located separately. For napping services, program provides napping cots for each child. Per director, napping supplies are taken home weekly by families for washing. Classrooms have acceptable ventilation and lighting. Toxins, detergents, cleaning supplies and are stored inaccessible to children. Classrooms have built-in smoke detectors, functioning carbon monoxide detector, telephone service, and fully charged fire extinguishers (3A:40BC). First aid kit was fully stocked.

At 9:35AM., LPA inspected the outdoor play areas. Outdoor play areas were enclosed with tall fencing. Outdoor space was observed free of debris or hazardous plants.

At 9:40AM., Based on observations, LPA confirmed broken slide in the outdoor play area. Advisory Note: Technical Violation (LIC9102TV) was issued.

Water services are provided with pitchers and water bottles.

(REFER TO 809-C FOR CONT.)

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PLAYGROUPS UNLIMITED - UNIVERSE OF COLORS	FACILITY NUMBER: 414004238
	VISIT DATE: 02/14/2023

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
26
27
28
29
30
31
32

(Page 2)
At 9:55AM LPA review facility records including five children’s files and six personnel files. Staff files reviewed included personnel's: Notice of Employee Rights (LIC9052); Personnel Record (LIC501); Transcripts; and 'Mandated Reporter Training' AB1207.

LPA reminded director to ensure staff's proof of required immunization are stored in the facility file. Advisory Note: Technical Assistance (LIC9102TA) was issued.

Children’s files reviewed and included the: Consent for Medical Treatment (LIC627); Updated Immunization Record, Identification of Emergency Information (LIC700); Personal Rights (LIC613A); and Notification of Parent’s Rights (LIC995).

Present staff member had their current CPR/ 1^st aid certification, which expires: 12/2024.

Emergency disaster drills are conducted every six months with the last drill completed on, 12/15/2022 and is properly logged. Families provide all meal serviced in facility. Refrigerators inspected are clean and in proper use.

LPA observed required posting including the: Facility License, Parent’s Rights (PUB393), Emergency Disaster Plan (LIC610), and Lead Testing Results.

LPA reviewed children’s medication during inspection.

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 (REFER TO 809C FOR CONT.)

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: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

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
PENINSULA CHILD CARE, 851 TRAEGER AVE., SUITE 360
SAN BRUNO, CA 94066

FACILITY NAME: PLAYGROUPS UNLIMITED - UNIVERSE OF COLORS	FACILITY NUMBER: 414004238
	VISIT DATE: 02/14/2023

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
26
27
28
29
30
31
32

(Page 3)
Based on today's inspection, no deficiencies were observed in the areas evaluated according to the Title 22 Division 12 Ca. Code of Regulations. Exit interview and report was reviewed with Eliana Coutin-Lyon, and signature of this form acknowledges receipt of these documents.

This report and rights to comment were discussed. This report must be available in the facility for public review. Notice was given 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: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis Gomez	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/14/2023

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/14/2023

LIC809 (FAS) - (06/04)

Page: 5 of 5