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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004865
Report Date: 05/12/2022
Date Signed: 05/12/2022 04:09:39 PM


Document Has Been Signed on 05/12/2022 04:09 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:AU P'TIT MONDE OF PENINSULAFACILITY NUMBER:
414004865
ADMINISTRATOR:RAMOUL, LYNDAFACILITY TYPE:
850
ADDRESS:1980 CLARKE AVENUETELEPHONE:
(650) 787-8434
CITY:EAST PALO ALTOSTATE: CAZIP CODE:
94303
CAPACITY:80CENSUS: 28DATE:
05/12/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
11:45 AM
MET WITH:Licensee, Shilpa and Director, LyndaTIME COMPLETED:
03:00 PM
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On May 12th, 2022 at approximately 11:45am, Licensing Program Analyst (LPA) Tapia-Mandujano met with licensee, Shilpa Badadare and Director, Lynda Ramoul for a pre-licensing inspection. The applicant is requesting a capacity of 80 children (ages 2 years to entry into first grade). The facility will operate Monday - Friday; 8:00 AM- 5:30 PM. The designated director for the facility is Lynda Ramoul. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor: Facility was measured today, however one classroom is not set up and will need to be remeasured. There is three bathrooms in the facility that is equipped with two toilets and two sinks, for a total of four toilets and four sinks available to children. There is additional sinks with water that are accessible to children deliver water that is no warmer than 120 degrees. There are separate bathrooms for staff usage.

The indoor space for children is observed by LPA, there is furnishings, toys and equipment for children and staff use that are clean and appropriate for use. There is storage space for children's personal belongings and cots to be utilized for napping children. Parents will provide the blanket and sheets for their child. Bedding will be sent home to be laundered weekly. Cots will be cleaned weekly or more often if needed. Children will be signed in and out electronically. Each classroom is equipped with a fire extinguisher, smoke and carbon monoxide detectors, and first aid kit. Facility is equipped with a kitchen area. Garbage cans have tight-fitting lids. The facility is adequately ventilated and free of insects and bugs. Facility will provide all food for the children. The facility plans to provide Breakfast, lunch and snacks daily. Cleaning products or other hazards will be stored separately. Medications will be stored in the classrooms inaccessible to the children; there will be a refrigerator for refrigerated medications. Isolation of ill children will be in Director's office. For drinking water children will bring their own individual water bottles to the facility each day, and will be allowed to have free access at any time. Facility will also offer filtered water as needed.

Outdoor: The outdoor area measures 3670.1 square feet allowing for 48 children. Facility will need to apply for an Outside Waiver. The yard is clean and all equipment appears to be in good condition. Outdoor area is fenced by at least a four foot gate all around. There is sufficient cushioning underneath the play structure. For access to drinking water, children will be bringing out their personal water bottles. Outdoor area provides shading for children.

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, Emergency Evacuation Procedures, Medication Policies, Isolation of Sick Children, Napping Requirements, Food Service, Transportation-none provided, Parents Rights, and Reporting Requirements. Required postings were observed during today's inspection. Facility will conduct disaster drills every 6 months and a log will be maintained for review upon request.

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SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:
DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:
DATE: 05/12/2022
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 2


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: AU P'TIT MONDE OF PENINSULA
FACILITY NUMBER: 414004865
VISIT DATE: 05/12/2022
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LPA received the following from Licensee, Shilpa Badadare during today's inspection:
*LIC 503 with immunization's
*Director's proof of Pertussis and TB

Applicant was reminded that all adults 18 and over responsible for administration or direct supervision of staff, persons who provides care and supervision to children, and staff who have contact with children, including employees and volunteers, must obtain a criminal record clearance or exemption, or transfer their existing clearance or exemption, prior to initial presence in a Child Care Center. A civil penalty of $100.00 minimum/day up to $500.00 maximum per day/per person will be assessed if this regulation is violated.

LPA discussed the safe sleep regulations with applicant and discussed the Child Care Licensing Safe Sleep webpage at https://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed applicant of the importance of checking for recalled infant devices on the United States Consumer Product Safety Commission (CPSC) website at https://www.cpsc.gov/ and recommended they register all infant devices with the CPSC to be notified of any recalls on their purchased equipment.

APPLICANT KNOWS FACILITY PLANS TO PROVIDE IMS:
This facility plans to provide Incidental Medical Services – IMS. For IMS information, see PIN 22-02-CCP. A Plan of Operation that includes IMS must be submitted to the Department. 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 with applicant, LIC 311A, Records To Be Maintained At The Facility, for child’s records, personnel records, administrative records, and documents to be posted
Community Care Licensing Division (CCLD) regularly sends information to licensed facilities, providers, and stakeholders by way of Provider Information Notices (PIN), Program Quarterly Update Newsletters and other important information communication platform. To receive important licensed-related information to licensed facilities, visit the CCLD Important Information website at https://www.cdss.ca.gov/inforesources/community-care-licensing/subscribe and select the Child Care option to receive email communication.

LPAs will recommend licensure of this facility for a capacity of 80 children once the following is corrected/completed/received and reviewed. Items marked **** will be required in order to receive a provisional license:

****Multipurpose Room set up
****Bathroom to set up
****All Staff to be fingerprinted and associated
****Outside Waiver Approved
Missing immunization for Licensee and Director
Director's Mandated Reporter Training

Exit interview conducted and report was reviewed with licensee, Shilpa Badadare and Director, Lynda Ramoul.
SUPERVISOR'S NAME: Cindy InterianoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR NAME: Leslit Tapia-MandujanoTELEPHONE: (650) 266-8800
LICENSING EVALUATOR SIGNATURE:

DATE: 05/12/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 05/12/2022
LIC809 (FAS) - (06/04)
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