414004416-10-28-2021-05-CC-CQUO-C88TUE-20211028150212

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004416
Report Date: 10/28/2021
Date Signed: 10/28/2021 03:02:41 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:	NEWTON AT LAUREL SM		FACILITY NUMBER:	414004416
ADMINISTRATOR:	CARMEN ZUNIGA		FACILITY TYPE:	840
ADDRESS:	303 36TH AVE.		TELEPHONE:	(650) 346-7939
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94403
CAPACITY:	50	CENSUS: 5	DATE:	10/28/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:30 PM
MET WITH:	Site Supervisor, Dominique Johnson		TIME COMPLETED:	03:30 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 October 28, 2021 at 12:30pm, Licensing Program Analyst (LPA) Catrina Quimbo met with site supervisor, Dominque Johnson, for a random, annual inspection. Purpose of the inspection was explained. Present, in the facility are 2 staff members (including site supervisor) and 5 enrolled children (school age) in care. Facility is operating within its capacity and is in compliance with staff / child ratio on this day. Facility is an after school program that operates day care from Monday - Friday 12:45pm to 6:00pm. With site supervisor, LPA inspected the day care areas for health and safety hazards. Currently, facility operates only in the Wesley Hall, Room #1, and outdoor area. Room#1 was kept clean and orderly. Facility is equipped with a fully charged fire extinguisher, smoke and carbon monoxide detector and fully stocked First Aid kit that is taken out to the outdoor area. Per site supervisor, there are no firearms or weapons on site. Facility has 3 bathrooms that include 5 toilets, 1 urinal and 3 sinks. LPA observed bathroom to be in good condition with appropriate sanitation products. Facility provides dry PM snacks. All food is stored in Room #1 and properly prepared to avoid contamination. Individual drinking bottles and other items are provided by parents, that are labeled and stored in Room #1. Children have access to refill water containers with accessible drinking fountain. Water pitcher and disposable cups are available if needed. Storage for children's belongings are located in Room#1. Facility has a working telephone on site. All cleaning solutions, poisons and other chemicals are stored in the classroom, inaccessible to children on high shelves. Facility has age appropriate furniture. There were a variety of age appropriate toys and materials available for children in care. (Continue Report on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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: NEWTON AT LAUREL SM	FACILITY NUMBER: 414004416
	VISIT DATE: 10/28/2021

NARRATIVE

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Parents are to sign children out through electronic application and electronic signatures. Outdoor area was observed to have age appropriate equipment and play structures with resilient padding.

Facility has license documentation and information in a red binder that is made accessible to all guardians. LPA advised documents to be displayed in a prominent place for parents to review. Site supervisor stated last emergency disaster drill was conducted with Laurel Elementary School. LPA advised site supervisor emergency disaster drills must be conducted and documented once every 6 months.

LPA reviewed facility records that included 5 children's records (all present during inspection) which were complete. LPA observed site supervisor's CPR and First Aid to be current and will expire 06/2023. LPA reviewed site supervisor's file and credentials which were complete and up to date.

Facility was informed that as of September 1, 2016, a person may not be employed or volunteer at a child care facility unless he or she has been immunized against influenza, pertussis, and measles or qualifies for an exemption pursuant to Health and Safety code 1596.7995 and 1597.662.

Site supervisor is aware that all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com. LPA observed the completion certificate on file. LPA encourages the head teacher to frequently visit our website at www.ccld.ca.gov for licensing regulations and new updates.

To improve the quality and value of the new inspection process, a survey will be sent to the email address provided. Please complete the survey and share your inspection experience. If you have any questions regarding the process or tools, please send them by email to inspectionprocess@dss.ca.gov. For additional information regarding the inspection and its tools and methods, please visit the Program website at www.cdss.ca.gov/inforesources/community-care-licensing/inspection-process.

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SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

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: NEWTON AT LAUREL SM	FACILITY NUMBER: 414004416
	VISIT DATE: 10/28/2021

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Incidental Medical Services (IMS) policy was discussed. Program is providing IMS at this time. 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

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

No deficiencies were cited today under CCR, Title 22, Division 12, Chapter 3.

A notice of site visit was given and must remain posted for 30 days.

Exit interview conducted and report was reviewed with the site supervisor, Dominique Johnson.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/28/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/28/2021

LIC809 (FAS) - (06/04)

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