430702323-8-23-2022-52-CC-BPLY-CHKQV6-20220823122950

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430702323
Report Date: 08/23/2022
Date Signed: 08/23/2022 12:29:58 PM

Document Has Been Signed on 08/23/2022 12:29 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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME:	NEIGHBORHOOD INFANT-TODDLER CENTER		FACILITY NUMBER:	430702323
ADMINISTRATOR:	MELISSA STEPHENS		FACILITY TYPE:	830
ADDRESS:	311 NORTH CALIFORNIA AVENUE		TELEPHONE:	(650) 321-3493
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94301
CAPACITY:	12	CENSUS: 11	DATE:	08/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:30 AM
MET WITH:	Hanh Tran- Asst. Director/Teacher		TIME COMPLETED:	12:42 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 8/23/22 at 10:30am, Licensing Program Analyst (LPA) Briana Plumboy conducted an Unannounced Annual / Random Inspection at the facility today. Upon arrival, LPA observed 11 infants at the facility as well as 5 fingerprint clear and associated staff. LPA toured the facility inside and out. Days and hours of operation are Monday through Friday 7:30am to 6:00pm. The facility is licensed to serve a maximum of 12 infants ages zero (0) to twenty two (2) years old. During the inspection, LPA observed the facility to be in compliance with staff supervision and ratio requirements and that all infants were attended to. The facility maintains an approved waiver to allow staff to prepare bottles for infants with formula provided by families. The Director understands the conditions of this waiver and understands waivers are granted at the discretion of the licensing agency. LPA observed that the facility is operating within the terms of the license and is in compliance with the approved fire clearance capacity. The facility was observed to be clean, safe, sanitary, and in good repair. Disinfectants, cleaning solutions, and all other items that are dangerous to infants were observed to be securely stored and inaccessible. Furniture and equipment was observed to be safe, in good condition, and free of sharp, loose, or pointed parts during today's inspection. The facility has age appropriate furniture and equipment, including infant cribs, cots, and changing tables within arms reach of a sink. Classroom furniture and equipment for infants were observed to be clean and operable. Infant cots and cribs were observed to be in good condition and cribs were observed without any extra items in them and covered with tight fitting linens. LPA also confirmed that cots are stored without linens touching and reminded the Director that during nap time cots should be arranged in the classroom allowing at least enough space for a walkway. Bottles brought from home were observed to be properly stored at the appropriate temperature. LPA observed bottles for infants brought from home are labeled with the infant's name and dated on a daily basis. The Director stated infant bottles are brought to the facility ready to consume and are sent home and disinfected at home. Staff also prepare bottles at the facility with formula See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: NEIGHBORHOOD INFANT-TODDLER CENTER	FACILITY NUMBER: 430702323
	VISIT DATE: 08/23/2022

NARRATIVE

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provided by families per the approved waiver. Storage containers for waste have tight fitting covers, changing tables are within arms length of a sink, and floors and carpeting are clean and free from obstructions. The Director understands that changing tables or any equipment used shall be disinfected in between diaper changes (should it be needed). Food storage areas in the classrooms were clean. Changing tables were clean and in good condition. The Director understands that when infants are sleeping in a crib or infant cot, there shall be at least one staff on that side of the partition wall separating the crib area of the classroom.

The outdoor area is surrounded by secured fencing and the outdoor surfaces are safe and age appropriate for infants. The outdoor play structure is designed for infants 0-3 years old. LPA observed that sign in/out is electronic.The facility maintains an updated roster of infants enrolled.

No weapons are stored on site and no bodies of water are on the premises. LPA observed fire extinguishers, smoke detectors, carbon monoxide detectors, a central alarm system, and complete first aid kits throughout the facility. Emergency disaster drills are performed as required, last of which was done in 8/23/22 at 8:55am. LPA reminded the Director that all fire safety items and equipment should be maintained at least every 12 months. LPA reviewed a random sample of infant's records and observed that there is a separate, complete, and current record for each infant enrolled in the center. LPA observed that infant needs and service plans are updated at least quarterly as required. LPA Plumboy observed the facility utilizes Lic. 9227 and documents safe sleep checks. The facility does not provide transportation.

This facility provides Incidental Medical Services – IMS. LPA reviewed storage of medication and equipment/supplies, and reviewed children’s, personnel, and administrative records. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Family Child Care Homes Section 102417. 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
At this time, there are no children requiring IMS

Director was encouraged to frequently visit our website at ccld.ca.gov for licensing regulations and updates.

See 809-C for continuance

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: NEIGHBORHOOD INFANT-TODDLER CENTER	FACILITY NUMBER: 430702323
	VISIT DATE: 08/23/2022

NARRATIVE

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Director is reminded that ALL assistants, volunteers, and staff, that are 18 years of age or older must be fingerprint cleared and associated to this facility prior to being in the presence of children in care or an immediate civil penalty will be assessed from $100 to $3000 per person, per incident. Director was reminded of the responsibility as a mandated reporter. All forms can be downloaded at www.ccld.ca.gov

LPA discussed the safe sleep regulations with Director 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 Director 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.

A notice of site visit was given and must remain posted for 30 days.

No deficiencies cited during today's inspection. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with Director.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/23/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/23/2022

LIC809 (FAS) - (06/04)

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