434404365-6-9-2022-52-CC-JWIS-CF8SQQ-20220609140506

Community Care Licensing

FACILITY EVALUATION REPORT

Facility Number: 434404365
Report Date: 06/09/2022
Date Signed: 06/09/2022 02:05:19 PM

Document Has Been Signed on 06/09/2022 02:05 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:	BRIGHT HORIZONS PALO ALTO SQUARE		FACILITY NUMBER:	434404365
ADMINISTRATOR:	LEE, MICHELLE		FACILITY TYPE:	840
ADDRESS:	3000 EL CAMINO REAL #3-110		TELEPHONE:	(650) 493-3777
CITY:	PALO ALTO	STATE: CA	ZIP CODE:	94306
CAPACITY:	27	CENSUS: 8	DATE:	06/09/2022
TYPE OF VISIT:	Required - 1 Year	UNANNOUNCED	TIME BEGAN:	10:00 AM
MET WITH:	Leah Ferry		TIME COMPLETED:	02:21 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 6/9/2022, Licensing Program Analysts (LPAs) Jonathan Williams and Melanie Otsuji arrived at the facility unannounced for the purposes of conducting a Required 1-Year Inspection. LPA was met by Director, Leah Ferry. Present for this inspection were the Director, one fingerprint cleared and associated staff member, and 8 children in care (two school-aged children and six preschool aged children). Two children present today in the facility are school-aged. Facility has an approved waiver allowing school-aged children to commingle with preschool-aged children. Waiver was observed to be posted in the facility. Facility operating hours are 8:00am-6:00pm M-F. The facility operates as a drop-in center. The facility was toured to conduct a health and safety inspection. At 10:00am, LPAs toured the facility classrooms. The school aged component consists of two classrooms. The classrooms are tidy and clean with heating and ventilation for safety and comfort. There are safe age-appropriate toys and learning materials available to children throughout the classrooms. All hazardous materials and toxins including disinfectants and cleaning solutions were observed to be made inaccessible to children during today's inspection. Furniture accessible to children was observed to be age-appropriate, in operable condition, and free of loose, sharp, or pointed parts. LPAs observed adequate amounts of paper towels and hand soap available to children in the bathroom during today's inspection. LPAs reviewed sign in/sign out sheet. LPAs observed 8 signatures out of 8 children present in the facility during today's inspection.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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: BRIGHT HORIZONS PALO ALTO SQUARE	FACILITY NUMBER: 434404365
	VISIT DATE: 06/09/2022

NARRATIVE

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At 10:42am, LPAs toured the food preparation area. AM/PM snack is provided and parents provide lunch meals for children. Refrigerator was observed to be maintained in working order and was found to be free of evidence of rodents and other vermin at this time. Menus are posted in public view.

The facility has multiple fully charged 3A40BC fire extinguishers and working telephone. Carbon monoxide detectors are fully functional. Smoke alarm system is serviced regularly, per Director. At least one staff member present today has current CPR/1st Aid certificate. The facility is in ratio today. Children's files and staff files were reviewed for proper documentation. Child's records for school-aged children were reviewed together with records for preschool aged children. All required forms are posted in public view. Facility roster was obtained.

Incidental Medical Services (IMS) policy was discussed. This facility provides IMS to children in care at this time. IMS Plan of Operation is on file at this time. 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. LPAs 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.

SUPERVISOR'S NAME: Wynn Norona	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR NAME: Jonathan Williams	TELEPHONE: (510) 622-2602
LICENSING EVALUATOR SIGNATURE:	DATE: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

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: BRIGHT HORIZONS PALO ALTO SQUARE	FACILITY NUMBER: 434404365
	VISIT DATE: 06/09/2022

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	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: 06/09/2022

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

FACILITY REPRESENTATIVE SIGNATURE:

DATE: 06/09/2022

LIC809 (FAS) - (06/04)

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