430710052-8-23-2022-52-CC-BPLY-CHKSE8-20220823134815

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 430710052
Report Date: 08/23/2022
Date Signed: 08/23/2022 01:48:22 PM

Document Has Been Signed on 08/23/2022 01:48 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:	OHLONE KIDS' CLUB		FACILITY NUMBER:	430710052
ADMINISTRATOR:	DANIELLE LANDUCCI		FACILITY TYPE:	840
ADDRESS:	950 AMARILLO AVENUE		TELEPHONE:	(650) 493-0774
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY:	80	CENSUS: 15	DATE:	08/23/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	12:49 PM
MET WITH:	Danielle Landucci- Director		TIME COMPLETED:	02:00 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 8/23/22 at 12:49pm Licensing Program Analyst (LPA) Briana Plumboy met with Director Danielle Landucci for an Unannounced Annual Inspection. Two (2) classrooms were toured for a health and safety inspection. There were fifteen (15) school-age children and five (4) staff present during the inspection. The facility operates from 12:00pm – 6:00pm.

The facility has age appropriate materials in both rooms that are observed to be clean and in good condition. The outdoor spaces used belong to the Ohlone Elementary School. All toxins, cleaning products, medications, and hazardous materials were observed to be in inaccessible areas during todays inspection. All sinks and toilets were observed to be clean and in proper working order. The food preparation areas were observed to be clean and free from hazards. All knives and cleaning products in the food prep areas were made inaccessible to children in care during today's inspection.

The facility is operating within its licensed capacity and is in ratio. All proper postings including the menu are made visible to parents and visitors by the front door. A physical census of the children and staff was taken and cross referenced with the sign-in and out log. LPA did not observe any bodies of water at the facility.

LPA obtained a sample of the children’s files and the staff files. All teachers’ files are complete, and children’s files were observed to be complete. Director Provided LPA Plumboy with a current copy of Lic. 9040 and Lic. 500.

Director was reminded that ALL 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 $3,000 per person, per incident. Director was reminded of the responsibility as a mandated reporter.

Continued on 809-C

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)

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: OHLONE KIDS' CLUB	FACILITY NUMBER: 430710052
	VISIT DATE: 08/23/2022

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

Director was reminded that California Law requires licensees to report unusual incidents or injuries to children in care, to child's parents, and to the Department of Social Services using the Unusual Incident/Injury form (LIC 624). Incidents must be reported within 24 hours by phone, fax, or email. LPA informed Director that all forms can be downloaded at www.ccld.ca.gov. Director was also informed that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every two (2) years by visiting www.mandatedreporterca.com.

Incidental Medical Services (IMS) policy was discussed. This facility provides IMS to children in care. Facility is following IMS plan on file. When any changes to the IMS plan is made, an updated Plan for Providing 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.

There has not been a fire/disaster drill documented yet this school year because the current school year began on August 11, 2022. The Director was reminded that any structural changes to the facility or additions to the childcare facility must be reported to Community Care Licensing.

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

This report was read and given to the Director for a signature. There are no deficiencies being cited today. This report shall remain on file for three (3) years. Appeal Rights were provided and exit interview conducted. A Notice of Site visit was given and must be posted for 30 days.

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)

Page: 2 of 2