414004628-1-2-2020-05-CC-PHSH-BKG26B-20200102160648

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004628
Report Date: 12/23/2019
Date Signed: 01/02/2020 04:06:52 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:	MY BUSY TOWN LEARNING CENTER		FACILITY NUMBER:	414004628
ADMINISTRATOR:	PADILLA, TIFFANY		FACILITY TYPE:	850
ADDRESS:	556 SAN MATEO AVENUE		TELEPHONE:	(650) 315-8936
CITY:	SAN BRUNO	STATE: CA	ZIP CODE:	94066
CAPACITY:	60	CENSUS:	DATE:	12/23/2019
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	08:45 AM
MET WITH:	Tiffany Padilla		TIME COMPLETED:	12:05 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	Licensing Program Analyst (LPA) Pandora Huffman-Smith met with the owner, Tiffany Padilla, today for a pre-licensing inspection. The applicant has requested a capacity of 60 children and will operate as a drop in child care center Monday - Friday from 8:00 AM to 6:00 PM. The facility current operates as open play and allows usage of the facility for birthday parties. The facility will continue to provide these services outside of the normal child care hours. The facility was inspected today for health and safety hazards and measured to calculate capacity. Indoor: The facility is a large indoor themed play area with large play structures, slides, balls and other play equipment. There is also a loft area that children can access by stairs and can either walk down or slide from different areas. There is an additional area in the back that is currently used for eating and birthday parties, but will be used for group learning activities and lunch area upon approval of license. The areas measure a total of 3624 square feet allowing for 103 children. The facility appears to be clean and equipped with a fire extinguisher, smoke detector, cubbies for children's personal belongings, two drinking water fountains for children, and plenty of toys and equipment for children. All furnishing, toys and equipment appear to be safe and in good condition. There is one bathroom for children's usage (labeled women's) that is equipped with three toilets and one sink. The bathroom appears to be clean and in good condition. There is an additional sink in the main play area for children's usage. There are a total of three toilets allowing for a capacity of 45 children and two sinks allowing for a total of 30 children. The applicant states that she will install a portable sink in order to be approved for 45 children. There is an additional bathroom (labeled men's) for staff usage. Isolation for ill children will be in the front sign-in area and the staff bathroom will be used for the child until parent arrives for pick up. Outdoor: The facility has no outdoor play area and is requesting a waiver due to operating on a drop-in basis only. Continued on page 2

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Pandora Huffman-Smith	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2019

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: MY BUSY TOWN LEARNING CENTER	FACILITY NUMBER: 414004628
	VISIT DATE: 12/23/2019

NARRATIVE

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This facility will provide Incidental Medical Services – IMS. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226.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

The facility will conduct and log disaster drills at least once every six months. The applicant states that the facility has been given approval by the San Bruno Fire Department, but CCL has not yet received the approval.

Requirements prior to licensure:

Fire clearance.
First aid kit.
Carbon Monoxide detector.
Stairs to second level storage/staff lounge and back area of the group learning activity space require to be made inaccessible to children.
Plan of operation for incidental medical services (IMS). Information on creating this plan was given to the applicant today.
Review of facility program description.
Management approval is required.
To be licensed for for 45 children, an additional sink is required.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Pandora Huffman-Smith	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 12/23/2019

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 12/23/2019

LIC809 (FAS) - (06/04)

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