414004754-3-16-2021-05-CC-HRCO-BZ6PMM-20210316112634

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 414004754
Report Date: 02/01/2021
Date Signed: 03/16/2021 11:27:54 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:	L'ACADEMY PRESCHOOL SAN MATEO		FACILITY NUMBER:	414004754
ADMINISTRATOR:	HELENA GENG		FACILITY TYPE:	850
ADDRESS:	608 N. EL CAMINO REAL		TELEPHONE:	(415) 361-1879
CITY:	SAN MATEO	STATE: CA	ZIP CODE:	94401
CAPACITY:	40	CENSUS: 0	DATE:	02/01/2021
TYPE OF VISIT:	Prelicensing	ANNOUNCED	TIME BEGAN:	11:00 AM
MET WITH:	Helena Geng		TIME COMPLETED:	01:30 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 Analyst (LPA) Haydee Caliboso met with Helena Geng and Vesna Bajic today for a pre-licensing inspection. During today’s inspection, COVID-19 technical assistance, guidance, and support were provided. The applicant has requested a capacity of 40 children ages 2 to 6 years old. The facility building that will be used for the program is on the lower level of a 2-story commercial building. The facility will operate Monday - Friday; 8:00 AM to 5:30 PM. The designated Director for the facility is Vesna Bajic. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity. Indoor: There are 2 classrooms that will be used for the program and the following square footage was calculated for each room: Classroom (#1) 380 sq. ft. allowing for a capacity of 10 children and Classroom (#2) 1,077 sq. ft. allowing for a capacity of 30 children. The classrooms and furniture equipment are clean and in good condition. Children’s toys and supplies are orderly, in good condition, and age appropriate. There is storage space for children's personal belongings and cots to be utilized for napping children. Cots will be cleaned daily or as needed. Parents will provide a sheet and blanket for their child. Bedding is sent home to be washed weekly or as needed. The facility is equipped with a fire extinguisher and smoke and carbon monoxide detectors. The facility has a working refrigerator where snack food is stored. Each classroom has garbage cans with tight-fitting lids. The facility has a designated backpack with a first aid kit and emergency supplies. Refrigerated medications will be stored separately from food. Medication will be administered with parental consent and will be kept in the child’s file for record. All medication will be logged when administered to children. The program will provide morning, lunch, and afternoon snacks daily through an outside vendor. Only disposable products will be used for food service. Continuation 809-C page 2.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2021

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: L'ACADEMY PRESCHOOL SAN MATEO	FACILITY NUMBER: 414004754
	VISIT DATE: 02/01/2021

NARRATIVE

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The facility has a total of 3 sinks and 3 toilets available for children to use. Classroom (#1) has a sink and a diaper changing table area available for children to use. Classroom (#2) has 2 sinks and 3 toilets available for children to use. All cleaning supplies and hazardous items are stored in a locked cabinet made inaccessible to children. Isolation area for ill preschool children is located in the corner at the front office/teacher space. Staff bathrooms will be used for ill children, if needed, until parents arrive for pick-up. Children will bring their own water bottle for indoor and outdoor use. In addition, pitchers of water and disposable cups will be provided for indoor and outdoor use. There is an elevator one staircase in the building located by the entrance to the classroom, and it will not be used for children during the hours of care. The stairs in the building will be gated for safety purposes. The building facility has a structural space attached to the classrooms that will only be used as a passageway between the classrooms and the outdoor area.

Outdoor: The outdoor play area that will be used in the program is located in a section of the garage parking lot underneath the building. The square footage calculated for the playground was 1620 sq. ft, allowing for a capacity of 21 children. The facility provided a request waiver for scheduled rotation for outdoor usage. No more than 21 children may be in the play area at a time. The facility’s outdoor playground is enclosed and gated by fencing and a folding steel security gate approximately 5 ft. tall. A planter will be used to close the gap beneath the folding steel security gate to prevent children from crawling underneath and accessing the other side of the garage parking lot. No children are allowed on the other side of the parking lot. The outdoor space was observed to be clean and equipped with toys that are age-appropriate for children. The parking structure will be used for shade when children are present. The playground has no climbing structures or slides. LPA reminded Helena Geng and Vesna Bajic to ensure ratio and supervision are observed at all times and gates are locked. The facility will conduct and log fire drills once every six months, and the log will be available upon request.

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 – staff will use positive discipline. Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements.
Cont. 809-C page 3.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2021

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: L'ACADEMY PRESCHOOL SAN MATEO	FACILITY NUMBER: 414004754
	VISIT DATE: 02/01/2021

NARRATIVE

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This facility will provide Incidental Medical Services – IMS. LPA reviewed storage area for medication and equipment/supplies, and reviewed forms that will be used. 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

LPA reviewed COVID-19 self-assessment guide and required postings were posted in the classrooms. An electronic copy of this 3 page report was emailed to Helena Geng and Vesna Bajic. Applicants were asked to review the report and return a signed copy of the report to LPA Haydee Caliboso.

Based on available square footage, sinks, and toilets, LPA Haydee Caliboso will recommend licensure of this facility for a maximum capacity of 40 children. The following is required prior to licensure:
· Complete and proof of fire alarm installed.
· Proof that gap/opening between the steel folding security gate is made inaccessible to prevent children from crawling to prevent children from crawling underneath and accessing the other side of the garage parking lot.
· Electric unit equipment outdoor is made inaccessible to children.
· Scheduled outdoor rotation.

SUPERVISOR'S NAME: Alma Malig	TELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Haydee R Caliboso	TELEPHONE: (650)266-8800
LICENSING EVALUATOR SIGNATURE:	DATE: 02/01/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/01/2021

LIC809 (FAS) - (06/04)

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