414004595-7-15-2021-05-CC-HKAR-C4XNY3-20210715105204

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004595
Report Date: 07/15/2021
Date Signed: 07/15/2021 10:52:07 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:	BUILDING KIDZ PACIFICA		FACILITY NUMBER:	414004595
ADMINISTRATOR:	WHEATLY, HALIE		FACILITY TYPE:	830
ADDRESS:	401 PALOMA AVENUE		TELEPHONE:	(650) 784-1474
CITY:	PACIFICA	STATE: CA	ZIP CODE:	94044
CAPACITY:	15	CENSUS: 11	DATE:	07/15/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:00 AM
MET WITH:	Liberty Rosario		TIME COMPLETED:	11:15 AM

NARRATIVE

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LPA Kaur made an unannounced required annual visit and met with the Director, Liberty Rosario. Present during the visit is the director, 3 staff and 11 infants. The infant program operates Monday - Friday from 7:30 AM to 5:30 PM

At 9:15 AM LPA toured the facility, indoor and outdoor, LPA kaur observed the following: Facility has 1 infant room. The facility is neat, clean and free of any health and safety hazards. Furnishings and equipment appear to be in good condition. LPA kaur observed infants were having breakfast. Classroom has a diaper changing table within arm’s reach of a sink. There is a refrigerator in the classroom for storing of infant bottles and food for infants ages 0-12 months. All bottles and food are labeled per regulation. The napping area is clean. There are sufficient cribs for infants to nap. There are first aid kits in classroom. The outdoor area was inspected and all toys and equipment appears to be safe and in good condition. There is sufficient cushioning underneath the infant play structure. Sandbox is properly covered. The facility’s medication policy is; prescribed medication is given to infants with parent authorization. The facility conducts disaster drills and the last drill was conducted on June, 2021.

LPA reviewed children and staff files. Facility uses app to sign in and out. Current CPR and first aid for staff was updated. LPA Kaur observed safety sleep log with date and initials. LPA received a copy of the facility roster during today’s visit.

LPA reviewed AB 1207 with the director. Director is aware that as of January 1, 2018 all staff is required to complete Mandated Reporter Training every two years. The training can be obtained online at www.mandatedreporterca.com.

No deficiencies are cited today. Notice of site visit is posted and shall remain posted for next 30 days.
Director, was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.cdss.ca.gov

The copy of report was reviewed and will be email to Director.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Harsimran Kaur	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 07/15/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/15/2021

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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