434400297-2-2-2022-52-CC-JWIS-CB9SCF-20220202124528

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434400297
Report Date: 02/02/2022
Date Signed: 02/02/2022 12:45:37 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:	CHILDREN'S PRE-SCHOOL CENTER, THE		FACILITY NUMBER:	434400297
ADMINISTRATOR:	KAY ERIKSON		FACILITY TYPE:	830
ADDRESS:	4000 MIDDLEFIELD ROAD T-1		TELEPHONE:	(650) 493-5770
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94303
CAPACITY:	45	CENSUS: 29	DATE:	02/02/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	08:50 AM
MET WITH:	Kay Erikson		TIME COMPLETED:	12:58 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 2/2/2022, Licensing Program Analyst (LPA) Jonathan Williams arrived at the facility unannounced for the purposes of conducting a Required 1-Year Inspection. LPA was met by Director, Kay Erikson. Present for this inspection are the Director, 12 fingerprint cleared and associated staff members, and 29 infants in care. The facility was toured to conduct a Health and Safety Inspection. LPA toured facility classrooms at 9:03am. The facility consists of four classrooms titled "Ladybugs", "Butterflies", "Dragonflies", and "Honeybees". The facility is tidy and clean with heating and ventilation for safety and comfort. There are toys and learning materials in the facility. There are no pools, hot tubs, ponds, or any other bodies of water accessible to children during today's inspection. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture and equipment accessible to children were observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. The facility has indoor space for infants that are physically separate from space used by the preschool component (434400296). The Director is aware that baby walkers, bouncers, exersaucers, and jumpers are not allowed in licensed care facilities. LPA toured food preparation area at 10:15am. Food preparation area was found to be free of litter, garbage, and evidence of rodents or other vermin. Food is protected from contamination and, per staff, contaminated food is discarded immediately. Food/beverages capable of rapid spoiling are properly stored. Bottles, dishes and containers of food brought by the infants’ authorized representatives are labeled with infant’s name. The infant changing tables are placed within arm’s reach of a sink while in use. Uncontaminated drinking water is available to children inside the facility.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

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: CHILDREN'S PRE-SCHOOL CENTER, THE	FACILITY NUMBER: 434400297
	VISIT DATE: 02/02/2022

NARRATIVE

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LPA toured outdoor play areas betwen 9:10am and 9:25am. Outdoor play areas were found to be in safe condition during this inspection. All play equipment is operable and age-appropriate at this time. Uncontaminated drinking water is available to children in the outdoor area.

The facility has a fully charged 3A40BC fire extinguisher, working smoke detector, working carbon monoxide detector, and working telephone. Multiple staff present today have current CPR/1st Aid certificates. The facility is in ratio today, with one teacher supervising no more than 4 infants. Children were observed to be visually supervised at all times, with no infants being left unattended. Children's files and staff files were reviewed for proper documentation. All required forms are posted in public view, including menus. Facility roster was obtained.

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.”

Director was reminded that all adults 18 and over, 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.

Director was reminded that California Law requires licensed Child Care Centers 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 electronic mail. LPA informed the Director that all forms can be downloaded at www.ccld.ca.gov and encouraged the Director to email childcareadvocatesprogram@dss.ca.gov to be included in the Child Care Quarterly Updates distribution list. The Director was also reminded that Mandated Reporter Training ("General" and "Child Care Providers") is required for all staff and is to be renewed every 2 years by visiting www.mandatedreporterca.com.

There are no deficiencies cited. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director. Appeal rights were provided to the Director and the signature on this form acknowledges receipt of these rights.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 02/02/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 02/02/2022

LIC809 (FAS) - (06/04)

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