434400134-8-31-2021-52-CC-BPLY-C6EQBJ-20210831120137

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400134
Report Date: 08/31/2021
Date Signed: 08/31/2021 12:01:44 PM

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:	LILLIPUT INFANT-TODDLER CENTER		FACILITY NUMBER:	434400134
ADMINISTRATOR:	HELER, VICKY		FACILITY TYPE:	830
ADDRESS:	3789 PARK BLVD.		TELEPHONE:	(650) 856-7407
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	9	CENSUS: 5	DATE:	08/31/2021
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	09:44 AM
MET WITH:	Maria (Vicky) Heler- Director		TIME COMPLETED:	12:15 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 8/31/21 at 9:44am, Licensing Program Analyst Briana Plumboy met with center Director Maria (Vicky) Heler for an Unannounced Random Inspection. The center and playground were toured to conduct a Health and Safety Inspection. The infant component of the center is located in the extension of the center. Present for this visit was 3 staff and 5 infants. Operation hours are M-F from 7:30am to 5:30pm. The center consist of one room which appears to be safe, clean, and in good repair. There appears to be adequate furniture, equipment, and toys which are age appropriate and appear to be in good condition. LPA Briana Plumboy did not observe any equipment that is prohibited. The indoor activity area is physically separate then the sleeping area. There is infant napping equipment available. There are no pools, spas, hot tubs, or free standing water accessible to children during today's inspection. The changing table is in arms reach of the sink. The playground surface appears to be maintained and in safe condition during today's inspection. The playground equipment appears to be safe and there are toys with sufficient cushioning underneath to absorb a fall during today's inspection. LPA did not observe any dangerous items accessible today, including medications, poisons, disinfectants or cleaning supplies, that could be dangerous to infants. All solid waste containers have tight fitting covers on, and appear to be in good repair. All required documents are visible and posted for public review. The center is in compliance with the sign in and out procedure. The center is equipped with a carbon monoxide, working telephone, a pull down fire alarm, and a fire extinguisher. LPA Plumboy observed the interaction between the staff and children in care, and did not observe any child left without visual supervision or unattended. The center roster was reviewed, and copy obtained. Children's files were complete and current, and contain a medical assessment, individual feeding plan, and a Needs and Services Plan. All staff have proof of the required units, have been fingerprinted, and have proof of immunization against influenza, pertussis, and measles, or provided a statement declining the influenza vaccination. All staff members have a current CPR/First Aid certificate. The facility is in ratio, and is in compliant with the capacity of the license today. 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: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LILLIPUT INFANT-TODDLER CENTER	FACILITY NUMBER: 434400134
	VISIT DATE: 08/31/2021

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

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

Licensee 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. Licensee 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 licensee Maria Heler 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 licensee Maria Heler 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.

See 809-D for deficiency cited today. Appeal rights provided and discussed. Exit interview conducted and report was reviewed with the licensee Maria Heler.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

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, 1515 CLAY STREET STE 1102
OAKLAND, CA 94612

FACILITY NAME: LILLIPUT INFANT-TODDLER CENTER	FACILITY NUMBER: 434400134
DEFICIENCY INFORMATION FOR THIS PAGE:	VISIT DATE: 08/31/2021

Deficiency Type POC Due Date / Section Number	DEFICIENCIES		PLAN OF CORRECTIONS(POCs)
Type B 09/03/2021 Section Cited	1 2 3 4 5 6 7	101427(j) Bottles, dishes and containers of food brought by the infant's authorized representative shall be labeled with the infant's name and the current date. None of children dishes and bottles were labeled.
	8 9 10 11 12 13 14	This requirement was not met as evidenced by: Based on observation, the infant's food and bottles are not labeled with the infant's names and current date. This poses a potential health and safety risk to children in care.	8 9 10 11 12 13 14	Failure to correct will result in a $100 per day civil penalty until corrected. Repeat violations are $250 per violation and $100 per day until corrected.
	1 2 3 4 5 6 7
	1 2 3 4 5 6 7

Failure to correct the cited deficiency(ies), on or before the Plan of Correction (POC) due date, may result in a civil penalty assessment.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 421-1324
LICENSING EVALUATOR NAME: Briana Plumboy	TELEPHONE: (510) 725-7005
LICENSING EVALUATOR SIGNATURE:	DATE: 08/31/2021

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 08/31/2021

LIC809 (FAS) - (06/04)

Page: 3 of 3