414004750-3-21-2021-05-CC-GASL-BZBMW8-20210321095754

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004750
Report Date: 03/09/2021
Date Signed: 03/21/2021 09:58:04 AM

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:	LATCHKEY ALTERNATIVE CENTER, THE		FACILITY NUMBER:	414004750
ADMINISTRATOR:	MATHEW FELDMAN		FACILITY TYPE:	840
ADDRESS:	1200 SKYLINE DRIVE		TELEPHONE:	(650) 755-8574
CITY:	DALY CITY	STATE: CA	ZIP CODE:	94015
CAPACITY:	60	CENSUS: 14	DATE:	03/09/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Nicole Feldman, Matthew Feldman, Michelle Harris		TIME COMPLETED:	02:30 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 Analysts (LPAs) Glenn Schnell and Sheran Lo met with Applicants Nicole and Matthew Feldman today for a pre-licensing inspection due to a change of ownership. The applicants have applied as a Limited Liability Corporation. This inspection included a technical assistance inspection for COVID-19 guidance and support. This facility is located at Roosevelt Elementary School (Jefferson School District), currently a closed elementary school due to the COVID-19 pandemic. The applicant is requesting a combination center; 54 preschool children (ages 2 years to entry into first grade) and 60 school age children (ages 5 to 13 years old). The facility will operate both programs Monday - Friday; 6:30 AM to 6:00 PM. The designated director/site supervisor for the facility is Nicole Feldman and her back up site supervisor will be Michelle Harris. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. Indoor: The rooms to be used for the school-age program are: 700B, and the multipurpose room on the elementary school campus. Room KB is currently being used temporarily for distance learning. Since the program is located on an elementary school site that would be functioning if not for the pandemic, this program is exempt from indoor square footage requirements, sink and toilet requirements, and outdoor space square footage requirements. The applicants will obtain a letter from the school superintendent that indicates approval to use the multipurpose room as well as the KB room, and superintendent must verify what the maximum capacities are for each room. Report continues on the next page.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A Schnell	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/09/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/09/2021

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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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: LATCHKEY ALTERNATIVE CENTER, THE	FACILITY NUMBER: 414004750
	VISIT DATE: 03/09/2021

NARRATIVE

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The indoor spaces for children are observed today to be clean and any furnishings, toys and equipment observed to be safe and in good condition. There is storage space for children's personal belongings located in the classroom. The facility is equipped with a fire extinguisher, smoke detectors, food prep/kitchen area with a sink/hot water, refrigerator, garbage cans with tight-fitting lids, and a first aid kit. The facility is adequately ventilated and free of insects and bugs.
The program provides two snacks and a lunch daily prepared by staff on site during the COVID-19 pandemic due to being onsite full time, until school is re-opened. Afterwards the program will offer a morning and afternoon snack only and the elementary school will provide the lunches. The program is only using disposable products for mealtimes during Covid-19, however, the kitchen in room 700A has a dishwasher to adequately clean dishes and utensils. Food will be stored in the kitchen separately from any cleaning products or other hazards. Medications, including individual IMS plans and medications will be stored in a high cabinet or refrigerator in the kitchen area inaccessible to the children.
There is one sink and one toilet designated for boys and one sink and one toilet designated for girls to use located in the classroom. Accessible toilets and sinks for children using the multipurpose and KB rooms are located in those individual rooms. The bathrooms are observed to be clean and with no health and safety hazards. The sinks accessible to children do not deliver warmer than 120 degrees. Facility has water fountains for children to drink water indoors. Since Covid, children currently bring their own water bottles and have access to refill throughout the day. All toxins and other hazardous items will be stored in a locked cabinet or room and will be inaccessible to children. Isolation of ill children will be located in the director’s office and staff bathroom will be used for the child until the parent arrives for pick up.
Report continues on the next page.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A Schnell	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2021

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: LATCHKEY ALTERNATIVE CENTER, THE	FACILITY NUMBER: 414004750
	VISIT DATE: 03/09/2021

NARRATIVE

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Outdoor: The school-age program is exempt from outdoor square footage requirements due to being located on a functioning school site. The outdoor area is enclosed by at least a four-foot fence (around the entire school) and observed to be clean, safe and equipped with toys and equipment for children. There are wood chips located under climbing structures. A separate boy/girl bathroom is available to children in the outdoor area. There is a drinking fountain outdoor for children's usage but due to the COVID-19 pandemic, children will bring their own water bottles. Shade for children is provided by the overhang connected to the building.

The following items were reviewed as part of today's visit: Record keeping for staff, children and facility records, Care and Supervision of the Children, Child Discipline Procedures-talking and redirection, Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Food Service, Transportation-none provided, Parents Rights, Reporting Requirements, and sign in/sign out procedures- method used is manual paper and pen. School age children can sign in/sign out for themselves with written consent by parents.
The facility will conduct monthly disaster drills and a log will be maintained for review upon request. The fire inspection was conducted on 10/16/20 and approved for 60 children. The requirement for Lead Water Testing was discussed (H&S Code 1597.16). Information was provided to applicants during today's inspection. Applicants have submitted a water test completed for the Elementary School. The rooms tested on the Lead Report indicates to be room 22 and 23 for rooms 700A and 700B.
This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. 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 Report continues on the next page.

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A Schnell	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2021

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: LATCHKEY ALTERNATIVE CENTER, THE	FACILITY NUMBER: 414004750
	VISIT DATE: 03/09/2021

NARRATIVE

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Today's inspection included reviewing COVID-19 required postings and protocols. LPA reviewed this guide with the applicants and requested the guide be completed and returned to LPA as part of completing the application process for licensure. Since this facility will be operating during the COVID-19 pandemic on a closed elementary school site, the applicant has submitted a letter from the school district giving permission to operate on the premises during the pandemic while the school is closed. Applicant was informed that access to available Personal Protective Equipment (PPE) may be available through the local childcare resource and referral agency.
An electronic copy of this four-page report was emailed to applicants Nicole and Matthew Feldman on 3/10/21. Applicant was asked to review the report and return a signed copy of the report to LPA Schnell.
LPA Schnell will recommend licensure of this facility for a capacity of 60 school age children once the following is received:

-Install Carbon Monoxide Detector
-Letter from School Superintendent for approval to use the multipurpose room, and state what the capacities are for each room
-Plan for use of multipurpose room, Sketch (LIC 999), and Emergency Care and Disaster Action Plan (LIC 610)
-Sketch (LIC 999) of KB room and Emergency Disaster Plan (LIC 610)
-Completed COVID-19 self-assessment
-Corrected Monthly Operating Statement (LIC 401)
-LPA receives a signed copy of this four-page pre-licensing report.
-Updated/corrected Job Descriptions, Personnel Policies, In-service Training Plan for Staff, Parent Handbook, IMS Plan, Discipline Policies, and Admissions Policies
FOR NICOLE: Updated LIC 215
FOR MICHELLE: Proof of completion of record keeping orientation
FOR MATTHEW: Updated LIC 215, Updated LIC 9108, 508

SUPERVISOR'S NAME: Ali Zebila	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Glenn A Schnell	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 03/10/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 03/10/2021

LIC809 (FAS) - (06/04)

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