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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004607
Report Date: 07/13/2021
Date Signed: 07/13/2021 12:22:39 PM

Document Has Been Signed on 07/13/2021 12:22 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:LITTLE FOOTSTEPSFACILITY NUMBER:
414004607
ADMINISTRATOR:MORIMOTO, JANICEFACILITY TYPE:
850
ADDRESS:1501 S. EL CAMINO REALTELEPHONE:
(650) 610-0715
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY: 42TOTAL ENROLLED CHILDREN: 0CENSUS: 18DATE:
07/13/2021
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
09:00 AM
MET WITH:Assistant Director, Darlene LunaTIME COMPLETED:
12:30 PM
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On 7/13/2021 at 9:00A.M. Licensing Program Analyst, (LPA) Luis J. Gomez met with the Assistant Director, Darlene Luna at the facility. Purpose of inspection was explained and was an unannounced annual inspection. Per assistant director, the facility administrator is currently on vacation. The preschool program is located at St. Andrews Lutheran Church. Preschool program operates out of two classrooms: Classroom #1 (4- 5 year old), Classroom #2 (2-3 year old) and utilizes two outdoor play yards: Garden area and Cemented play area. Off-limits area are the facility kitchen. Hours of operation are Monday- Friday 8:00am- 5:30pm. The program operates year around. Present is the Assistant Director and 3 staff supervising 18 children. Facility was operating within capacity limits of the license on this day. LPA inspected facility with Assistant Director for health and safety hazards.

At 9:05A.M., LPA inspected classroom #1 and #2 and observed the following: Classrooms were clean and had a variety age appropriate toys, blocks and books for the children. All playthings inspected were in good repair. Classrooms had carpeted areas for group reading time. Entry ways are equipped with child safety gates and children cubbies for added storage. Classrooms had several child size tables and chairs for snack and activities. Napping cots are available and stored in each classroom. Per assistant director, linins are washed weekly at the facility. Children’s bathrooms were kept clean with adequate supplies. Staff use separate restroom in the next building. At 9:56, LPA observed a broken toilet lid in the bathroom in classrooms #1. Per assistant director, toilet lid has been broken for one week.

At 9:25A.M., LPA inspected the outdoor door play areas. LPA observed, Outdoor play areas were completely enclosed with tall fencing. Basketball hoop in cemented play area was properly anchored. All outdoor playthings were in good repair. Outdoor play area is kept clean and free of debris. For acceptable water, facility uses refillable water bottle. Classrooms had acceptable ventilation and natural lighting. Facility had a smoke/ carbon monoxide detector combo and there a fully charged fire extinguishers (3A40BC) located in the kitchen. First aid kit was fully stocked.

Cindy Interiano
Luis Gomez
DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 07/13/2021
This report must be available at Child Care and Group Home facilities for public review for 3 years.

LIC809 (FAS) - (06/04)
Page: 1 of 3
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: LITTLE FOOTSTEPS
FACILITY NUMBER: 414004607
VISIT DATE: 07/13/2021
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(Page 2)

At 11:00A.M., LPA reviewed facility roster, two children's files and four personnel records. All children files and personnel files are complete. All staff had criminal clearances on file. Staff's CPR/ 1st aid certification is current expiring: 1/25/2022. All staff had required mandated reporter training certifications which were current. Licensing information was properly posted in facility hallway. Facility is documenting and conducting required emergency disaster drills, with the last drill conducted on 4/2021. Program provides snack and lunch. All food products inspected were current.

Incidental Medical Services (IMS) was discussed. Per assistant director, facility has no children who need IMS services at this time. When any IMS is provided, a Plan for Providing IMS must be submitted to the Department. The following information regarding Americans with Disabilities Act (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: www.ada.gov/childqanda.htm.

During inspection,


· Assistant Director was reminded, as of September 1, 2016, all Staff and Volunteers must provide proof of immunization against pertussis, measles, and influenza, or qualifies for an exemption, pursuant to Health and Safety code 1596.7995 and 1597.662.
· Assistant Director was reminded about Mandated Reporter training available on CCLD website. Training must be completed every 2 years. Training can be taken online at www.mandatedreporterca.com
· Assistant Director was reminded about the Provider Information Notices (PINs) on CCLD website.
·LPA provided COVID-19 Technical Assistance guidance including: Child In-take procedure, Health safety review, Social distancing, Mask wearing and Regular disinfecting of high surfaces.

(Continuation on Page 3)
SUPERVISOR'S NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 2 of 3
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: LITTLE FOOTSTEPS
FACILITY NUMBER: 414004607
VISIT DATE: 07/13/2021
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(Page 3)
Based on today's inspection, no deficiencies were observed in the areas evaluated according the Title 22 Division 12 Ca. Code of Regulations. Exit interview was conducted with Assistant Director, Darlene Luna and her signature of this form acknowledges receipt of these documents.

>This report and rights to comment and appeal were discussed. This report must be available in the facility for public review. Notice of site inspection was posted. Facility was advised any additional questions to call Office, M-F, 8am-5pm, 650-266-8800 or 1-844-538-8766. Website: www.ccld.ca.gov
SUPERVISOR'S NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Luis Gomez
LICENSING EVALUATOR SIGNATURE:

DATE: 07/13/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 07/13/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3