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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004406
Report Date: 10/10/2019
Date Signed: 10/10/2019 10:22:13 AM

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:BAYSHORE ELEMENTARY SCHOOL DISTRICTFACILITY NUMBER:
414004406
ADMINISTRATOR:YEARGIN, KHANHFACILITY TYPE:
850
ADDRESS:155 ORIENTE STREETTELEPHONE:
(415) 467-5443
CITY:DALY CITYSTATE: CAZIP CODE:
94014
CAPACITY:30CENSUS: 10DATE:
10/10/2019
TYPE OF VISIT:Annual/RequiredUNANNOUNCEDTIME BEGAN:
08:35 AM
MET WITH:Ashley AtkinsonTIME COMPLETED:
10:50 AM
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Licensing Program Analyst (LPA) Mok conducted an unannounced required inspection today. LPA met with the Head Teacher, Ashley Atkinson, and another teacher, June Zhang. The purpose of the inspection was explained to them. There were 10 children with 2 staff upon LPA arrival. The preschool program is run in Room # 101 at the Bayshore Elementary School. The preschool program has AM and PM sessions. The facility operation hours are Monday to Friday from 8:15am to 11:15am; PM session from 12:15pm to 3:15pm. The program was granted with the Outdoor Playground Waiver to share the playground with the elementary students by schedules. LPA inspected the facility for health and safety hazard. The facility was clean and in order. The temperature and lighting were adequate. All toxins and harmful objects were either locked or made inaccessible to the daycare children. The door of the facility is secured by the security lock, so the people cannot get into the room without the key card. Sign in/out sheets are located at the table by the entrance. Sign in/out sheets were reviewed during the inspection. There were plenty of the age-appropriate toys, piano, sandbox, water table, books, learning material, and children furniture available to children. Those items were in good condition. All electrical outlets were covered. Daycare children bring their own water bottles to school, but the school still has a water fountain available for the children in the classroom. Waste basket had a tide lid. There was an adjacent children bathroom in the classroom. The bathroom had a toilet and a sink with children size available for the children. The bathroom was clean and free of harmful objects. Staff bathroom is available on campus. Emergency bag and first aid supplies were available in the classroom. Right amounts of cubbies with children's names available for the children to store their own belongings in the classroom. The facility provides snacks to the daycare children only. The daycare children don't take nap at school, the napping equipment is not needed. However, the facility still has it available in case some children need it. The outdoor playground is adjacent to the classroom. The playground is shared with the Kindergarten by schedule. LPA inspected the playground during the inspection. The playground was completely fenced. There was a play structure installed in the playground with wood chip underneath as soft cushioning to prevent injury. The fire drill and disaster drill are conducted monthly. All required postings were posted. All staff have current CPR/First Aid training certificate available. The certificates will be expired in 7/2020 and 3/9/2021. All staff has completed the required Child Abuse Mandated Reporter Training. The certificates were reviewed during the inspection. Per Teacher Zhang, there were no children on special medication. Incidental Medical Services (IMS) policy was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. When any IMS is provided, an updated Plan of Operation that includes IMS must be submitted to the Department. The following information regarding ADA was provided: US Department of Justice (USDOJ) toll-free ADA Information Line at (800) 514-0301 (voice)/ (800) 514-0383 (TTY) and link to publication: Commonly Asked Questions about Child Care Centers and the ADA, available at http://www.ada.gov/childqanda.htm. Children files and roster were reviewed during the inspection. LPA also obtained a copy of the roster from licensee during the inspection.

This report and notice of site visit were discussed with the licensee and must be made available to the public upon request. For a quarterly update on Licensing information, go to the CCL website: www.ccld.ca.gov. For Provider Information Notice: ccld.ca.gov/PG5098.htm.
SUPERVISOR'S NAME: Alma MaligTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Cindy MokTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 10/10/2019
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/10/2019
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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