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Department of
SOCIAL SERVICES

Community Care Licensing


FACILITY EVALUATION REPORT

Facility Number: 434404366
Report Date: 06/09/2022
Date Signed: 06/09/2022 02:02:45 PM


Document Has Been Signed on 06/09/2022 02:02 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 SQUAREFACILITY NUMBER:
434404366
ADMINISTRATOR:LEE, MICHELLEFACILITY TYPE:
830
ADDRESS:3000 EL CAMINO REAL #3-100TELEPHONE:
(650) 493-3777
CITY:PALO ALTOSTATE: CAZIP CODE:
94306
CAPACITY:16CENSUS: 0DATE:
06/09/2022
TYPE OF VISIT:Required - 1 YearUNANNOUNCEDTIME BEGAN:
10:00 AM
MET WITH:Leah FerryTIME COMPLETED:
02:21 PM
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On 06/09/2022 Licensing Program Analysts (LPAs) Melanie Otsuji and Jonathan Williams conducted an UNANNOUNCED ANNUAL REQUIRED INSPECTION. LPAs met with Director, Leah Ferry. Also present during today's visit was a preschool staff member and 7 preschool aged children. Currently the facility does not have any infant aged children enrolled nor any infant staff present. Upon arrival LPA provided facility representative the form LIC 125. The facility was toured to conduct a Health and Safety Inspection. This program current operates Monday - Friday 8:00am - 6:00pm. Also on site are a Preschool and School Age component. This facility operates as a Drop In/Back Up center.

Two classrooms were inspected for age appropriate furnishings, equipment, and adequate storage for children’s belongings. LPAs observed the cleanliness of floors and surfaces, the presence of working carbon monoxide detector, smoke detectors/fire alarms and two fully charged fire extinguishers size 3A-40-BC that is accessible throughout the facility. The classrooms have diaper changing stations that are within arm’s reach of the sink.There are no pools, hot tubs or other accessible bodies of water. Cleaning supplies/toxins are stored inaccessible to children during the inspection and all required postings are present. The facility requires children to bring their own lunches daily but does provide AM/PM snacks. Children bring their own water bottles and the facility refills them with a water dispenser. The center also conducts and documents fire and earthquake drills once every 6 months and the logs show that drills were conducted on 5/2/2022.

A copy of the facility personnel roster and children’s roster were available for review and copy was obtained. LPA did not review files on today's date as there were no children enrolled nor staff employed for the infant program on today's date. LPA reviewed Director's file and Director has current CPR/First Aid certification. Staff interview also conducted and documented.
Please see LIC 809-C for continuation..
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
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: 434404366
VISIT DATE: 06/09/2022
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This facility provides Incidental Medical Services – IMS. LPA did not need to review medication during the inspection as the facility did not currently have any medication stored. For IMS information see Evaluator Manual - Regulation Interpretations and Procedures for Child Care Centers Sections 101173 and 101226. 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

Facility representative 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.

LPA discussed the safe sleep regulations with Director and discussed the Child Care Licensing Safe Sleep webpage athttps://www.cdss.ca.gov/inforesources/child-care-licensing/public-information-and-resources/safe-sleep as an additional resource. LPA also informed facility representative 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.

No deficiencies found on today's date. A notice of site visit was given and must remain posted for 30 days. Exit interview conducted and report was reviewed with the Director, Leah Ferry.
SUPERVISOR'S NAME: Wynn NoronaTELEPHONE: (510) 622-2593
LICENSING EVALUATOR NAME: Melanie OtsujiTELEPHONE: (510) 341-5559
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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