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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004417
Report Date: 11/19/2021
Date Signed: 11/19/2021 05:04:41 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 UPPER LAUREL(MENLO PARK CITY SCHOOL DIS)FACILITY NUMBER:
414004417
ADMINISTRATOR:KREMONIC, BETTYFACILITY TYPE:
840
ADDRESS:275 ELLIOTT DRIVETELEPHONE:
(650) 918-8297
CITY:MENLO PARKSTATE: CAZIP CODE:
94025
CAPACITY:60CENSUS: 13DATE:
11/19/2021
TYPE OF VISIT:Case Management - OtherUNANNOUNCEDTIME BEGAN:
03:00 PM
MET WITH:Betty and RubyTIME COMPLETED:
04:20 PM
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Licensing Program Analyst (LPA) Tapia-Mandujano conducted a case management inspection in response to a written request received via email on 11/1/21 from licensee Tal Tamir. Purpose of inspection was explained. LPA met with Site Supervisor, Betty and staff, Ruby.

The request is to add the Library, Collaboration area in front of library, and the gym for after school program. The program, being a school age program and operating on a functioning school site, is exempt from meeting square footage requirements for indoor/outdoor space and the sink/toilet to child ratio requirements.

LPA inspected the library, collaboration area in front of library, and gym for health and safety hazards. LPA observed the space to be safe, clean, and free of hazards.

The following rooms are approved for use effective today; First Floor:Collaboration area in front of Library, Second Floor: ‘Steam A,’ ‘Steam B,’ and Collaboration area outside of ‘Steam B.’ Program has been granted use of First Floor: Collaboration area near main stairway and Second Floor: Collaboration area in front of Room 24 in addition to Library, Collaboration Area in front of the library, and the gym (all first floor).

Fingerprint clearances for staff working and associated to this location were verified today. Clearances are centrally associated to another Newton facility location (Newton-Baywood, license 414001240).
Licensee was reminded to stay current on all updates to policies, procedures and licensing regulations. Information can be obtained at www.ccld.ca.gov

***No deficiencies were cited against the facility under CCR,Title 22, Div. 12, Ch. 1. ***

Copy of this report was emailed to applicant and director to TAL@NEWTONCENTER.ORG Signed copy of this report will be kept in the facility file and made available for public review. Notice of Site Visit must be posted for 30 days. Desk Duty is available Monday through Friday between 8:00 AM - 5:00 PM at (650) 266-8800. Website for forms and Regulations: www.cdss.ca.gov.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8864
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 350-2554
LICENSING EVALUATOR SIGNATURE:

DATE: 11/19/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 11/19/2021
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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