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

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 414004881
Report Date: 04/26/2022
Date Signed: 04/26/2022 04:17:04 PM

Document Has Been Signed on 04/26/2022 04:17 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:CLC FOOTHILL PRESCHOOLFACILITY NUMBER:
414004881
ADMINISTRATOR:ALBARAKAT, NOORFACILITY TYPE:
850
ADDRESS:815 ALLERTON STREETTELEPHONE:
(650) 385-8381
CITY:REDWOOD CITYSTATE: CAZIP CODE:
94063
CAPACITY: 21TOTAL ENROLLED CHILDREN: 26CENSUS: 19DATE:
04/26/2022
TYPE OF VISIT:PrelicensingUNANNOUNCEDTIME BEGAN:
12:20 PM
MET WITH:Noor AlbarakatTIME COMPLETED:
02:50 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 April 26th, 2021 at approximately 12:20pm, Licensing Program Analyst (LPA) Tapia-Mandujano met with Director, Noor Albarakat for a pre-licensing inspection. The applicant is requesting a capacity of 21 children (ages 2 years to entry into first grade). The facility will operate Monday - Friday; 8:30 AM- 4:30 PM. The designated director for the facility is Noor Albarakat. The facility was inspected today, indoor and outdoor, for health and safety hazards and measured to calculate capacity.

Indoor: The program will operate in classroom #1. This classroom measures 915 square feet exceeding the desired capacity of 21 children. There is a bathroom in the classroom that is equipped with one toilet and one sink. There is another bathroom in classroom #2 that is also equipped with one toilet and one sink that will be used for children for a total of two toilets and two sinks available to children. There is an additional sink with water fountain in the classroom. Sinks accessible to children deliver water that is no warmer than 120 degrees. There are separate bathrooms for staff usage. Classroom #2, with exception of the bathroom is off limits to children. A gate is installed in Classroom #2 to separate the bathroom and classroom.

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. Classroom is equipped with a fire extinguisher, smoke and carbon monoxide detectors, and first aid kit. Facility is equipped with a kitchen area that connects Room #1 and #2. Garbage cans have tight-fitting lids. The facility is adequately ventilated and free of insects and bugs. Parents will provide all food for the children. The facility plans to provide am/pm snacks daily. Cleaning products or other hazards will be stored separately. Medications will be stored in the Entrance area inaccessible to the children; there will be a refrigerator for refrigerated medications. Isolation of ill children will be by teacher's office on a sick cot. 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 6374 square feet allowing for 84 children. 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. There are large trees in the outdoor area which provide shading for children.

Continued on Page 2...
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE: DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE: DATE: 04/26/2022
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 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: CLC FOOTHILL PRESCHOOL
FACILITY NUMBER: 414004881
VISIT DATE: 04/26/2022
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 Continued..

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.

LPA received the following from Director, Noor Albarakat during today's inspection:
*LIC 200A
*LIC 308
*LIC 401
*LIC 503
*LIC 9182: Transfer Request for all staff
*Director Packet: Transcripts, Certificates of Completion: CPR & First Aid, Preventative Health Practices, Mandated Reporter Training, Orientation, LIC 9108, Proof of immunization: Measles, Pertussis, and Influenza/or declaration to opt out.
*Job Description
*In-Service Training Plan
*Admission Agreement
*List of Furniture

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.

Continued on Page 3...
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
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: CLC FOOTHILL PRESCHOOL
FACILITY NUMBER: 414004881
VISIT DATE: 04/26/2022
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 Continued...

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 120 children once the following is corrected/completed/received and reviewed. Items marked **** will be required in order to receive a provisional license:

****Fire Clearance Granted
Missing Forms

Exit interview conducted and report was reviewed with Director, Noor Albarakat.
SUPERVISORS NAME: Cindy Interiano
LICENSING EVALUATOR NAME: Leslit Tapia-Mandujano
LICENSING EVALUATOR SIGNATURE:

DATE: 04/26/2022
I acknowledge receipt of this form and understand my licensing appeal rights as explained and received.
FACILITY REPRESENTATIVE SIGNATURE:

DATE: 04/26/2022
LIC809 (FAS) - (06/04)
Page: 3 of 3