414004416-10-12-2022-05-CC-CQUO-CK5UKL-20221012153915

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004416
Report Date: 10/12/2022
Date Signed: 10/12/2022 03:39:50 PM

Document Has Been Signed on 10/12/2022 03:39 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:	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: 28	DATE:	10/12/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:45 PM
MET WITH:	Carmen Zuniga		TIME COMPLETED:	03:45 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 12, 2022 at approximately 12:45pm, Licensing Program Analyst (LPA) Catrina Quimbo conducted an unannounced, annual inspection. LPA met with site supervisor, Carmen Zuniga, and explained the purpose of the inspection. Facility is an after school program that operates from Monday to Friday 12:45pm to 6:00pm. Present during LPA's visit included 28 school age children and 4 staff members. Facility is operating within capacity limits and ratio during LPA's visit. At approximately 1:15pm, LPA inspected day care areas with site supervisor. Program operates in Wesley Hall in Room #1, gym area, and outdoor area. LPA observed Room# 1 to be clean and equipped with age appropriate toys and materials. Classroom is properly ventilated and furnished with age appropriate equipment. LPA observed Room #1 to be equipped with a working carbon monoxide detector. Facility also has multiple fully charged fire extinguishers on site. Cleaning supplies, poisons and other hazardous materials are stored inaccessible, in room's high shelves. Storage for children's belongings are located inside Room #1. LPA observed electrical outlets in day care areas to be made inaccessible with child safety covers. LPA observed bathrooms to be in good condition with appropriate sanitation products. Facility provides dry afternoon snacks. All food is stored in Room #1's cabinet, that is made inaccessible to children behind a child safety lock. Facility has a working phone on site. Phone number listed for facility is current. Garbage cans on site were observed to have tight fitting lids. Per site supervisor, garbage bins are emptied daily. Water is accessible, indoors and outdoors, with refillable water stations and/or gallons of water pitchers. Program utilizes emergency backpacks with fully stocked first aid kits that are taken out to the outdoor area. Entire outdoor area is fully fenced by an at least 4 ft. high fence. LPA observed outdoor area to be clean, free of any debris or loose articles. Outdoor area is equipped with play structures that have resilient padding underneath. (Continued on Page 2...)

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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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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: 10/12/2022

NARRATIVE

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Children are signed into facility by Newton program's staff daily. Children's authorized representatives are to sign children out with electronic signatures. Facility has license documentation and information in Newton binder that is made available for review.

Emergency drills are conducted at least once every six months and are properly logged. Last emergency drill was conducted 09/14/2022.

LPA reviewed facility records that included 10 children's records which were complete. All Newton staff on site during LPA's visit have a current, CPR certificate. Site supervisor's CPR will expire 08/2024.

LPA reviewed all Newton staff's file on site during LPA's visit, which were also complete. Staff have record of required immunizations that were made available, current Mandated Reporter certificates and required credentials.

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 encourages the site supervisor 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) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

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: 10/12/2022

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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

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.

A notice of site visit was given and must remain posted for 30 days. Failure to comply with posting requirements shall result in an immediate civil penalty of $100.

Exit interview conducted and report was reviewed with the site supervisor, Carmen Zuniga.

SUPERVISOR'S NAME: Cindy Interiano	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Catrina Quimbo	TELEPHONE: 650-266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 10/12/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 10/12/2022

LIC809 (FAS) - (06/04)

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