<meta name="robots" content="noindex">
Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004802
Report Date: 08/06/2021
Date Signed: 08/06/2021 12:50:06 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:SPALTER, RIVKAHFACILITY NUMBER:
414004802
ADMINISTRATOR:SPALTER, RIVKAHFACILITY TYPE:
810
ADDRESS:TELEPHONE:
(954) 665-1497
CITY:SAN MATEOSTATE: CAZIP CODE:
94402
CAPACITY:14CENSUS: 4DATE:
08/06/2021
TYPE OF VISIT:PrelicensingANNOUNCEDTIME BEGAN:
10:15 AM
MET WITH:Applicant, Rivkah Spalter TIME COMPLETED:
01:00 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
On 8/6/2021 at 10:15 A.M., Licensing Program Analysts (LPAs), Luis J. Gomez met with applicant, Rivkah Spalter for a schedule prelicensing inspection at the facility. Inspection included a technical assistance review for COVID-19 prevention and mitigation measures. Present is the applicant, applicant’s husband, two helpers and four children. (1 infant 2 Preschool Age and 1 School Age). Approved Fire Clearance Request (STD850) was received by the Department on 7/16/2021. Applicant rents the home, which is a two level, two bedroom and two bathroom house. Days and hours of operation are Monday - Friday, 8:00 AM. to 5:00 PM. Daycare Area: Downstairs:Backroom (Playroom), Bathroom #1 and Outdoor Play Area. Off-limit Area: Downstairs:T.V. Room (Pass through only), Laundry Room (Pass through only), Office, Kitchen, Dining Room and Living Room. Upstairs:Bedroom #1, Bedroom #2 and Bathroom #3. LPA inspected home with applicant for health and safety hazards.

At 10:20 A.M., The following was observed: Day-care area was clean and orderly with a variety of age appropriate toys, books and blocks for the children. Furniture and playthings inspected appeared in good condition. Children’s mats and napping supplies were stored in playroom. Several cubbies were available for added storage of children’s belongings. Playroom had child size table and several chairs for snack and activities. Per applicant, all meals will be served in the playroom. Bathroom #1 was in operating condition with adequate supplies. All accessible trash bins and outlets had been properly covered. Detergents and cleaning supplies were made inaccessible, stored laundry room. Facility has functioning cell phone, smoke/ carbon monoxide detector combo and fire extinguishers (3A:40:BC) located in the playroom.

Outdoor Play Area was review during inspection. LPA observed the following: Outdoor Area was completely enclosed with tall fencing. Backyard area had large shed for added storage. Shed was inspected by LPA. All children’s supplies and playthings were in good repair. Per applicant, children will be supervised at all times.

(REFER TO 809-C FOR CONT.)

SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
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: SPALTER, RIVKAH
FACILITY NUMBER: 414004802
VISIT DATE: 08/06/2021
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
26
27
28
29
30
31
32
(Page 2)

Per applicant, there are no guns or weapons in the home. Bedrooms were free of hazards or dangerous conditions. Isolation area for an ill child will be in the playroom. Applicant was informed that the Department must be notified that prior to use of any off-limits areas. Applicant's Mandated Reporter Training is current, expiring: 9/1/2021. Licensing forms and posting requirements were reviewed with the applicant. LPA discussed licensing regulations and the capacity requirements. Any children under 10 years of age will be counted in the capacity. Applicant stated she plans to provide snack for the children. LPA reminded applicant that food brought from home should be properly labeled. Applicant understands that fire/earthquake drills are to be conducted every six months and recorded. Applicant understands that baby walkers, bouncers, and excersaucers are not allowed. Smoking is prohibited in family childcare homes. Applicant was informed that all adults 18 -years and older, living in the home or assisting with children, must have their criminal record clearance and be associated to the facility by submitting an LIC 9182 with copy of CA DL or CA ID, prior to having any contact with day-care children. Failure to do so could result in an immediate civil penalty of $100.00 each day. Applicant was reminded that as of September 1, 2016, a person may not be employed or volunteer at a childcare facility unless he or she has been immunized for pertussis, measles, and influenza or qualifies for an exemption pursuant to Health and Safety Code 1596.7995 and 1597.662.

Incidental Medical Services (IMS) was discussed. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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.

Applicant was reminded about the Mandated Reporter training available on CCLD website. Training must be completed every 2 years by the applicant and all staff hired. Training can be taken online: www.mandaterreporterca.com.


Applicant was informed about the Provider Information Notices (PINs) on CCLD website. Safe Sleep handout and PINs were discussed. (REFER TO 809-C FOR CONT.)
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
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: SPALTER, RIVKAH
FACILITY NUMBER: 414004802
VISIT DATE: 08/06/2021
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
26
27
28
29
30
31
32
(Page 3)

Applicant can also email childcareadvocatesprogram@dss.ca.gov and ask to be added to the email list for the updates.

During today’s inspection, applicant submitted LIC9182 for herself and her husband.

Prior to recommended for licensure, applicant must complete the following:



Post required forms: LIC610, PUB394, in visible location
Install child safety gate next to storage shed in the Outdoor Play Area
Install barrier over water pump in the Outdoor Play Area
Remove planting pots and hazardous items from Outdoor Play Area
Received Criminal Record Clearance for all adults
Renew Applicant's CPR/ 1st aid Certification
Submit Prelicensing Readiness Guide (LIC9217)
Submit COVID-19 Self-Assessment
Submit Change of Director Packet for Chai Preschool

Copy of this report was provided to applicant. This report will be kept in the facility file and will be made available for public review upon request. Desk Duty is available Monday through Friday between 8 AM - 5 PM at (650) 266-8800
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Luis GomezTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 08/06/2021
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/06/2021
LIC809 (FAS) - (06/04)
Page: 3 of 3